P-ethoxy nucleic acids for bcl2 inhibition

ABSTRACT

Provided herein are improved delivery systems for oligonucleotides, said delivery system comprising a liposome that comprises neutral phospholipids and a P-ethoxy oligonucleotide, which targets a BCL2-encoding polynucleotide. Methods of treating patients with said delivery systems are also provided.

The present application claims the priority benefit of U.S. provisionalapplication No. 62/487,302, filed Apr. 19, 2017, the entire contents ofwhich is incorporated herein by reference.

BACKGROUND OF THE INVENTION 1. Field of the Invention

The present invention relates generally to the field of medicine. Moreparticularly, it concerns liposomal formulations of P-ethoxyoligonucleotides that hybridize to a BCL2 polynucleotide gene productand methods of making and using such formulations in medicine, even moreparticularly in the treatment of cancers that have high expression orincreased activity of the BCL2 gene.

2. Description of Related Art

Bcl-2 is a protein that is involved in regulating apoptosis orprogrammed cell death. Over-expression of Bcl-2 prevents the inductionof apoptosis in response to cellular insults such as treatment withchemotherapeutic agents. Bcl-2 is over-expressed in more than 90% offollicular B-cell non-Hodgkins lymphoma due to a chromosomalrearrangement and is the key factor in the initiation of thismalignancy. Bcl-2 is also overexpressed in a wide variety of solidtumors (it is estimated to be over-expressed in 40 percent of cancers).For example, Bcl-2 overexpression has been associated with theprogression of prostate cancer from hormone dependence to hormoneindependence and may contribute to the relative drug resistant phenotypetypically observed in hormone independent prostate cancer.

SUMMARY OF THE INVENTION

Provided herein are compositions and methods that induce growthinhibition and/or apoptosis in a wide range of cancer cells controlledby Bcl2. Bcl2 expression is targeted by a non-toxic nuclease resistantoligonucleotide that targets Bcl2-encoding polynucleotides incombination with a neutral liposome that prevents Bcl2 proteinexpression, thus eliminating the pool of available Bcl2 protein.

In one embodiment, compositions are provided comprising a population ofoligonucleotides that hybridize to a BCL2 polynucleotide gene product.In some aspects, the oligonucleotides of the population are composed ofnucleoside molecules linked together through phosphate backbonelinkages, wherein at least one of the phosphate backbone linkages ineach oligonucleotide is a P-ethoxy backbone linkage, and wherein no morethan 80% of the phosphate backbone linkages in each oligonucleotide areP-ethoxy backbone linkages. In some aspects, at least one of thephosphate backbone linkages in each oligonucleotide is a phosphodiesterbackbone linkage. In some aspects, the oligonucleotides of thepopulation comprise a sequence according to any one of SEQ ID NOs: 1-3.In some aspects, the oligonucleotides of the population comprise asequence according to SEQ ID NO: 1. In one aspect, the oligonucleotidesof the population comprise a sequence according to SEQ ID NO: 1 and thephosphate backbone linkages at least between nucleotides 5 and 6,between nucleotides 7 and 8, between nucleotides 9 and 10, betweennucleotides 11 and 12, and between nucleotides 14 and 15 of theoligonucleotides of the population are phosphodiester backbone linkages.In some aspects, the oligonucleotides of the population comprise asequence according to SEQ ID NO: 2. In one aspect, the oligonucleotidesof the population comprise a sequence according to SEQ ID NO: 2 and thephosphate backbone linkages at least between nucleotides 5 and 6,between nucleotides 7 and 8, and between nucleotides 9 and 10 of theoligonucleotides of the population are phosphodiester backbone linkages.In some aspects, the oligonucleotides of the population comprise asequence according to SEQ ID NO: 3. In various aspects, theoligonucleotides of the population inhibit the expression of Bcl2. Insome aspects, the composition is lyophilized.

In some aspects, 10% to 80% of the phosphate backbone linkages areP-ethoxy backbone linkages; 20% to 80% of the phosphate backbonelinkages are P-ethoxy backbone linkages; 30% to 80% of the phosphatebackbone linkages are P-ethoxy backbone linkages; 40% to 80% of thephosphate backbone linkages are P-ethoxy backbone linkages; 50% to 80%of the phosphate backbone linkages are P-ethoxy backbone linkages; or60% to 70% of the phosphate backbone linkages are P-ethoxy backbonelinkages, or any range derivable therein. In some aspects, 20% to 90% ofthe phosphate backbone linkages are phosphodiester backbone linkages;20% to 80% of the phosphate backbone linkages are phosphodiesterbackbone linkages; 20% to 70% of the phosphate backbone linkages arephosphodiester backbone linkages; 20% to 60% of the phosphate backbonelinkages are phosphodiester backbone linkages; 20% to 50% of thephosphate backbone linkages are phosphodiester backbone linkages; or 30%to 40% of the phosphate backbone linkages are phosphodiester backbonelinkages, or any range derivable therein. In various aspects, at least5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 60%,65%, 70%, 75%, 80%, 85%, 90%, or 95%, or any value therein, of thephosphate backbone linkages are P-ethoxy backbone linkages. In variousaspects, at most 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%,60%, 65%, 70%, 75%, 80%, 85%, 90%, or 95%, or any value therein, of thephosphate backbone linkages are phosphodiester backbone linkages. Incertain aspects, the phosphodiester backbone linkages are distributedthroughout the oligonucleotides. As such, the oligonucleotides are notchimeric molecules. In some aspects, the oligonucleotides do notcomprise a phosphorothioate backbone linkage.

In some aspects, the oligonucleotides of the population have a sizeranging from 7 to 30 nucleotides. In certain aspects, theoligonucleotides of the population have a size ranging from 12 to 25nucleotides. In various aspects, the oligonucleotides of the populationhave a size of at least 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17,18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 nucleotides. Thesize range may be an average size of the oligonucleotides in thepopulation.

In some aspects, the oligonucleotides of the population have an averagesize of 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23,24, 25, 26, 27, 28, 29, or 30 nucleotides, wherein no more than 5, 6, 7,8, 8, 9, 10, 11, 11, 12, 13, 14, 15, 15, 16, 17, 18, 19, 20, 20, 21, 22,23, or 24, respectively, of the phosphate backbone linkages in eacholigonucleotide is a P-ethoxy backbone linkage. In some aspects, theoligonucleotides of the population have an average size of 7, 8, 9, 10,11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28,29, or 30 nucleotides and at least 2, 2, 2, 2, 3, 3, 3, 3, 4, 4, 4, 4,4, 5, 5, 5, 5, 5, 5, 6, 6, 6, 6, or 6, respectively, of the phosphatebackbone linkages in each oligonucleotide is a phosphodiester backbonelinkage. By way of example, the oligonucleotides of the population mayhave an average size of 18 nucleotides, wherein no more than 14 of thephosphate backbone linkages in each oligonucleotide is a P-ethoxybackbone linkage; the oligonucleotides of the population may have anaverage size of 20 nucleotides, wherein no more than 16 of the phosphatebackbone linkages in each oligonucleotide is a P-ethoxy backbonelinkage; the oligonucleotides of the population may have an average sizeof 25 nucleotides, wherein no more than 20 of the phosphate backbonelinkages in each oligonucleotide is a P-ethoxy backbone linkage; or theoligonucleotides of the population may have an average size of 30nucleotides, wherein no more than 24 of the phosphate backbone linkagesin each oligonucleotide is a P-ethoxy backbone linkage.

In some aspects, the population of oligonucleotides comprises a singlespecies of oligonucleotides. In other aspects, the population ofoligonucleotides comprises at least two species of oligonucleotides. Asingle species of oligonucleotide may have the same nucleotide sequencebut either have or lack P-ethoxy linkages in different positions withinthe molecule. As such, the population may be homogeneous as to thenucleotide sequence and heterogeneous as to the distribution ofphosphodiester backbone linkages among the oligonucleotides of thepopulation. In addition, the population may be heterogeneous as to thenumber of P-ethoxy backbone linkages and phosphodiester backbonelinkages among the oligonucleotides of the population. As a non-limitingexample, a first portion of the oligonucleotides of the population mayhave 70% P-ethoxy linkages and 30% phosphodiester linkages while asecond portion of the oligonucleotides of the population may have 60%P-ethoxy linkages and 40% phosphodiester linkages. In some aspects, thepopulation of oligonucleotides comprises antisense oligonucleotides,short interfering RNAs (siRNAs), microRNAs (miRNAs), or piwiRNAs(piRNAs).

In various aspects, the composition further comprises phospholipids. Insome aspects, the phospholipids and oligonucleotides are present at amolar ratio of from about 5:1 to about 100:1. In some aspects, theoligonucleotides and phospholipids form an oligonucleotide-lipidcomplex, such as, for example, a liposome complex. In some aspects, atleast 75%, 76%, 77%, 78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%,88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99% of theliposomes are less than 5 microns in diameter. In some aspects, at least75%, 76%, 77%, 78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%,89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99% of theliposomes are less than 4 microns in diameter. In some aspects, thepopulation of oligonucleotides are incorporated in the population ofliposomes.

In some aspects, the phospholipids are uncharged or have a neutralcharge at physiologic pH. In some aspects, the phospholipids are neutralphospholipids. In certain aspects, the neutral phospholipids arephosphatidylcholines. In certain aspects, the neutral phospholipids aredioleoylphosphatidyl choline. In some aspects, the phospholipids areessentially free of cholesterol.

In one embodiment, pharmaceutical compositions are provided comprising acomposition of oligonucleotides and phospholipids of the presentembodiments and a pharmaceutically acceptable carrier. In some aspects,the composition further comprises a chemotherapeutic agent.

In one embodiment, methods are provided for delivering a therapeuticallyeffective amount of an oligonucleotide to a cell comprising contactingthe cell with a pharmaceutical composition of the present embodiments.In some aspects, the method is a method of treating hyperplasia, cancer,an autoimmune disease, or an infectious disease.

In one embodiment, methods are provided for treating a subject withcancer, an autoimmune disease, or an infectious disease comprisingadministering to the subject a therapeutically effective amount of apharmaceutical composition of the present embodiments. In some aspects,the subject is a human. In some aspects, the cancer is a bladder, blood,lymphoma, pancreas, bone, bone marrow, brain, breast, colon, esophagus,stomach, head and neck, kidney, liver, lung, prostate, skin, testis,tongue, ovary, or uterine cancer. In some aspects, the lymphoma isgerminal center B-cell-like diffuse large B cell lymphoma, activatedB-cell-like subtype diffuse large B cell lymphoma, mantle cell lymphoma,or Burkitt lymphoma. In some aspects, the leukemia is myeloid leukemia.In some aspects, the autoimmune disease is Lupus erythematosis,Spondyloarthropathy, Sjogren's disease, Crohn's disease, diabetesmellitus, multiple sclerosis, or rheumatoid arthritis. In some aspects,the infectious disease is a bacterial infection, fungal infection, viralinfection, or parasitic infection. In some aspects, the composition isadministering subcutaneously, intravenously, or intraperitoneally. Insome aspects, the method further comprises administering at least asecond anticancer therapy to the subject. In some aspects, the secondanticancer therapy is a surgical therapy, chemotherapy, radiationtherapy, cryotherapy, hormone therapy, immunotherapy, or cytokinetherapy. In some aspects, the immunotherapy is a checkpoint blockadetherapy. In some aspects, administration of the composition reducesexpression of Bcl2 protein in the patient.

An oligonucleotide includes an antisense nucleic acid molecule thatspecifically hybridizes to a nucleic acid molecule encoding a targetprotein or regulating the expression of the target protein. “Specifichybridization” means that the antisense nucleic acid molecule hybridizesto the targeted nucleic acid molecule and regulates its expression.Preferably, “specific hybridization” also means that no other genes ortranscripts are affected. An oligonucleotide can be a single-strandednucleic acid and may comprise 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17,18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or more nucleobases.In particular aspects the oligonucleotide can comprise 15 to 30, 19 to25, 20 to 23, or 21 contiguous nucleobases. In certain embodiments, theoligonucleotide inhibits the translation of a gene that promotes growthof a cancerous or pre-cancerous or hyperplastic mammalian cell (e.g., ahuman cell). An oligonucleotide may induce apoptosis in the cell, and/orinhibit the translation of an oncogene or other target gene. In certainembodiments, the oligonucleotide component comprises a single species ofoligonucleotide. In other embodiments, the oligonucleotide componentcomprises a 2, 3, 4 or more species of oligonucleotide that target 1, 2,3, 4, or more genes. The composition may further comprise achemotherapeutic or other anti-cancer agent, which may or may not beincorporated in a lipid component or liposome of the invention. Infurther embodiments, the oligonucleotide component is incorporatedwithin the liposome or lipid component.

“Entrap,” “encapsulate,” and “incorporate” refer to the lipid orliposome forming an impediment to free diffusion into solution by anassociation with or around an agent of interest, e.g., a liposome mayencapsulate an agent within a lipid layer or within an aqueouscompartment inside or between lipid layers. In certain embodiments, thecomposition is comprised in a pharmaceutically acceptable carrier. Thepharmaceutically acceptable carrier may be formulated for administrationto a human subject or patient.

In certain embodiments, the lipid component has an essentially neutralcharge because it comprises a neutral phospholipid or a net neutralcharge. In certain aspects a neutral phospholipid may be aphosphatidylcholine, such as DOPC, egg phosphatidylcholine (“EPC”),dilauroylphosphatidylcholine (“DLPC”), dimyristoylphosphatidylcholine(“DMPC”), dipalmitoylphosphatidylcholine (“DPPC”), distearoylphosphatidylcholine (“DSPC”), dilinoleoylphosphatidylcholine,1,2-diarachidoyl-sn-glycero-3-phosphocholine (“DAPC”),1,2-dieicosenoyl-sn-glycero-3-phosphocholine (“DEPC”),1-myristoyl-2-palmitoyl phosphatidylcholine (“WPC”),1-palmitoyl-2-myristoyl phosphatidylcholine (“PMPC”),1-palmitoyl-2-stearoyl phosphatidylcholine (“PSPC”),1-stearoyl-2-palmitoyl phosphatidylcholine (“SPPC”),1-palmitoyl-2-oleoyl phosphatidylcholine (“POPC”), 1-oleoyl-2-palmitoylphosphatidylcholine (“OPPC”), or lysophosphatidylcholine. In otheraspects the neutral phospholipid can be a phosphatidylethanolamine, suchas dioleoylphosphatidylethanolamine (“DOPE”), distearoylphophatidylethanolamine (“DSPE”), dimyristoylphosphatidylethanolamine (“DMPE”), dipalmitoyl phosphatidylethanolamine(“DPPE”), palmitoyloleoyl phosphatidylethanolamine (“POPE”), orlysophosphatidylethanolamine. In certain embodiments, the phospholipidcomponent can comprise 1, 2, 3, 4, 5, 6, 7, 8, or more kinds or types ofneutral phospholipid. In other embodiments, a phospholipid component cancomprise 2, 3, 4, 5, 6 or more kinds or type of neutral phospholipids.

In certain embodiments, a lipid component can have an essentiallyneutral charge because it comprises a positively charged lipid and anegatively charged lipid. The lipid component may further comprise aneutrally charged lipid(s) or phospholipid(s). The positively chargedlipid may be a positively charged phospholipid. The negatively chargedlipid may be a negatively charged phospholipid. The negatively chargedphospholipid may be a phosphatidylserine, such as dimyristoylphosphatidylserine (“DMPS”), dipalmitoyl phosphatidylserine (“DPPS”), orbrain phosphatidylserine (“BPS”). The negatively charged phospholipidmay be a phosphatidylglycerol, such as dilauroylphosphatidylglycerol(“DLPG”), dimyristoylphosphatidylglycerol (“DWG”),dipalmitoylphosphatidylglycerol (“DPPG”), distearoylphosphatidylglycerol (“DSPG”), or dioleoylphosphatidylglycerol(“DOPG”). In certain embodiments, the composition further comprisescholesterol or polyethyleneglycol (PEG). In other embodiments, thecomposition is essentially free of cholesterol. In certain embodiments,a phospholipid is a naturally-occurring phospholipid. In otherembodiments, a phospholipid is a synthetic phospholipid.

Liposomes can be made of one or more phospholipids, as long as the lipidmaterial is substantially uncharged. It is important that thecomposition be substantially free of anionic and cationic phospholipidsand cholesterol. Suitable phospholipids include phosphatidylcholines andothers that are well known to persons that are skilled in this field.

Another aspect of the present invention involves methods for deliveringoligonucleotide to a cell comprising contacting the cell with a neutrallipid composition of the invention. The methods will provide aninventive composition in an effective amount. An effective amount is anamount of therapeutic component that attenuates, slows, reduces oreliminates a cell, condition, or disease state in a subject. The cellmay be comprised in a subject or patient, such as a human. The methodmay further comprise a method of treating cancer or other hyperplasticcondition. The cancer may have originated in the bladder, blood, bone,bone marrow, brain, breast, colon, esophagus, gastrointestine, gum,head, kidney, liver, lymph node, lung, nasopharynx, neck, prostate,skin, stomach, testis, tongue, ovary, or uterus. In certain embodiments,the method further comprises a method of treating a non-cancerousdisease or hyperplastic condition. The cell may be a pre-cancerous or acancerous cell. In certain embodiments, the compositions and methodsinhibit the growth of the cell, induce apoptosis in the cell, and/orinhibit the translation of an oncogene. The oligonucleotide may inhibitthe translation of a gene that is overexpressed in the cancerous cell.

In certain embodiments, the methods of the invention further compriseadministering an additional therapy to the subject. The additionaltherapy may comprise administering a chemotherapeutic (e.g., paclitaxelor docetaxel), a surgery, a radiation therapy, and/or a gene therapy. Incertain aspects the chemotherapy is docetaxel, paclitaxel, cisplatin(CDDP), carboplatin, procarbazine, mechlorethamine, cyclophosphamide,camptothecin, ifosfamide, melphalan, chlorambucil, busulfan, nitrosurea,dactinomycin, daunorubicin, doxorubicin, bleomycin, plicomycin,mitomycin, etoposide (VP16), tamoxifen, raloxifene, estrogen receptorbinding agents, taxol, gemcitabien, navelbine, farnesyl-proteintansferase inhibitors, transplatinum, 5-fluorouracil, vincristin,vinblastin, methotrexate, or combinations thereof. In certainembodiments the chemotherapy is a taxane such as docetaxal orpaclitaxel. The chemotherapy can be delivered before, during, after, orcombinations thereof relative to a neutral lipid composition of theinvention. A chemotherapy can be delivered within 0, 1, 5, 10, 12, 20,24, 30, 48, or 72 hours or more of the neutral lipid composition. Theneutral lipid composition, the second anti-cancer therapy, or both theneutral lipid composition and the anti-cancer therapy can beadministered intratumorally, intravenously, intraperitoneally,subcutaneously, orally or by various combinations thereof.

It is contemplated that any embodiment discussed in this specificationcan be implemented with respect to any method or composition of theinvention, and vice versa. Furthermore, compositions of the inventioncan be used to achieve the methods of the invention.

As used herein, “essentially free,” in terms of a specified component,is used herein to mean that none of the specified component has beenpurposefully formulated into a composition and/or is present only as acontaminant or in trace amounts. The total amount of the specifiedcomponent resulting from any unintended contamination of a compositionis therefore well below 0.05%, preferably below 0.01%. Most preferred isa composition in which no amount of the specified component can bedetected with standard analytical methods.

As used herein the specification, “a” or “an” may mean one or more. Asused herein in the claim(s), when used in conjunction with the word“comprising,” the words “a” or “an” may mean one or more than one.

The use of the term “or” in the claims is used to mean “and/or” unlessexplicitly indicated to refer to alternatives only or the alternativesare mutually exclusive, although the disclosure supports a definitionthat refers to only alternatives and “and/or.” As used herein “another”may mean at least a second or more.

Throughout this application, the term “about” is used to indicate that avalue includes the inherent variation of error for the device, themethod being employed to determine the value, or the variation thatexists among the study subjects.

Other objects, features and advantages of the present invention willbecome apparent from the following detailed description. It should beunderstood, however, that the detailed description and the specificexamples, while indicating preferred embodiments of the invention, aregiven by way of illustration only, since various changes andmodifications within the spirit and scope of the invention will becomeapparent to those skilled in the art from this detailed description.

BRIEF DESCRIPTION OF THE DRAWINGS

The following drawings form part of the present specification and areincluded to further demonstrate certain aspects of the presentinvention. The invention may be better understood by reference to one ormore of these drawings in combination with the detailed description ofspecific embodiments presented herein.

FIG. 1—Liposomal BCL2 antisense does not inhibit the viability of normalperipheral blood mononuclear cells. The ability of liposomal BCL2antisense to inhibit the viability of normal peripheral bloodmononuclear cells was tested by incubating liposomal BCL2 antisensecorresponding to one of SEQ ID NO: 1 with the cells for four days.

FIGS. 2A-J—Liposomal BCL2 antisense inhibits the viability of germinalcenter B-cell-like subtype diffuse large B cell lymphoma cells. Theability of liposomal BCL2 antisense to inhibit the growth of germinalcenter B-cell-like subtype diffuse large B cell lymphoma cells wastested in ten human germinal center B-cell-like subtype diffuse large Bcell lymphoma cell lines: DOHH-2 (FIG. 2A), SU-DHL-4 (FIG. 2B), SU-DHL-6(FIG. 2C), SU-DHL-10 (FIG. 2D), OCI-LY-18 (FIG. 2E), OCI-LY-19 (FIG.2F), WSU-DLCL2 (FIG. 2G), RL (FIG. 2H), OCI-LY-1 (FIG. 2I), and OCI-LY-7(FIG. 2J).

FIGS. 3A-C—Liposomal BCL2 antisense inhibits the viability of activatedB-cell-like subtype diffuse large B cell lymphoma cells. The ability ofliposomal BCL2 antisense to inhibit the growth of activated B-cell-likesubtype diffuse large B cell lymphoma cells was tested in three humanactivated B-cell-like subtype diffuse large B cell lymphoma cell lines:SU-DHL-2 (FIG. 3A), U-2932 (FIG. 3B), and RI-1 (FIG. 3C).

FIGS. 4A-B—Liposomal BCL2 antisense inhibits the viability of lymphomacells. The ability of liposomal BCL2 antisense to inhibit the growth oflymphoma cells was tested in two human lymphoma cell lines: GRANTA-519(mantle cell lymphoma; FIG. 4A) and Ramos (Burkitt lymphoma; FIG. 4B).

FIGS. 5A-C—Liposomal BCL2 antisense inhibits the viability of myeloidleukemia cells. The ability of liposomal BCL2 antisense to inhibit thegrowth myeloid leukemia cells was tested in three human myeloid leukemiacell lines: K562 (FIG. 5A), MV-4-11 (FIG. 5B), and Kasumi-1 (FIG. 5C).

DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

Bcl-2 is a potential therapeutic target for cancer, such as, forexample, aggressive NHL. To inhibit the expression of Bcl-2 protein, thepresent invention provides compositions and methods for delivery of ananti-BCL2 oligonucleotide (e.g., an inhibitor of gene expression) to acell via a lipid composition, in certain aspects a lipid compositionwith a net charge of about zero, i.e., a neutral lipid composition,which allows it to be delivered systemically via intravenous infusion.These methods may be effectively used to treat a cancer.

I. LIPIDS AND LIPOSOMES

“Liposomes” is used herein to mean lipid-containing vesicles having alipid bilayer, as well as other lipid carrier particles that can entrapor incorporate antisense oligonucleotides. As such, liposome is ageneric term encompassing a variety of unilamellar, multilamellar, andmultivesicular lipid vehicles formed by the generation of enclosed lipidbilayers or aggregates. In addition, liposomes may have an undefinedlamellar structure. Liposomes may be characterized as having vesicularstructures with a phospholipid bilayer membrane and an inner aqueousmedium. Multilamellar liposomes have multiple lipid layers separated byaqueous medium. They form spontaneously when phospholipids are suspendedin an excess of aqueous solution. The lipid components undergoself-rearrangement before the formation of closed structures and entrapwater and dissolved solutes between the lipid bilayers (Ghosh andBachhawat, 1991). However, the present invention also encompassescompositions that have different structures in solution than the normalvesicular structure. For example, the lipids may assume a micellarstructure or merely exist as non-uniform aggregates of lipid molecules.

Liposomes are a form of nanoparticles that are carriers for delivering avariety of drugs into a diseased tissue. Optimal liposome size dependson the target tissue. In tumor tissue, the vasculature is discontinuous,and pore sizes vary from 100 to 780 nm (Siwak et al., 2002). Bycomparison, pore size in normal vascular endothelium is <2 nm in mosttissues, and 6 nm in post-capillary venules. Negatively chargedliposomes are thought to be more rapidly removed from circulation thanneutral or positively charged liposomes; however, recent studies haveindicated that the type of negatively charged lipid affects the rate ofliposome uptake by the reticulo-endothelial system (RES). For example,liposomes containing negatively charged lipids that are not stericallyshielded (phosphatidylserine, phosphatidic acid, andphosphatidylglycerol) are cleared more rapidly than neutral liposomes.Interestingly, cationic liposomes(1,2-dioleoyl-3-trimethylammonium-propane [DOTAP]) andcationic-liposome-DNA complexes are more avidly bound and internalizedby endothelial cells of angiogenic blood vessels via endocytosis thananionic, neutral, or sterically stabilized neutral liposomes (Thurstonet al., 1998; Krasnici et al., 2003). Cationic liposomes may not beideal delivery vehicles for tumor cells because surface interactionswith the tumor cells create an electrostatically derived binding-sitebarrier effect, inhibiting further association of the delivery systemswith tumor spheroids (Kostarelos et al., 2004). However, neutralliposomes appear to have better intratumoral penetration. Toxicity withspecific liposomal preparations has also been a concern. Cationicliposomes elicit dose-dependent toxicity and pulmonary inflammation bypromoting release of reactive oxygen intermediates, and this effect ismore pronounced with multivalent cationic liposomes than monovalentcationic liposomes, such as DOTAP (Dokka et al., 2000). Neutral andnegative liposomes do not appear to exhibit lung toxicity(Guitierrez-Puente et al., 1999). Cationic liposomes, while efficientlytaking up nucleic acids, have had limited success for in vivo genedown-regulation, perhaps because of their stable intracellular natureand resultant failure to release nucleic acid contents. Lipids withneutral charge or lipid compositions with a neutralized charge, e.g.,1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC), are used herein becauseof the neutral properties and success in delivering antisenseoligonucleotides in vivo.

The present invention provides methods and compositions for associatingan oligonucleotide, such as an antisense oligonucleotide, with a lipidand/or liposome. The oligonucleotide may be incorporated in the aqueousinterior of a liposome, interspersed within the lipid bilayer of aliposome, attached to a liposome via a linking molecule that isassociated with both the liposome and the oligonucleotide, entrapped ina liposome, complexed with a liposome, dispersed in a solutioncontaining a lipid, mixed with a lipid, combined with a lipid, containedas a suspension in a lipid, contained or complexed with a micelle, orotherwise associated with a lipid. The liposome orliposome/oligonucleotide-associated compositions provided herein are notlimited to any particular structure in solution. For example, they maybe present in a bilayer structure, as micelles, or with a “collapsed”structure. They may also simply be interspersed in a solution, possiblyforming aggregates that are not uniform in either size or shape.

A. Lipids

Lipids are fatty substances that may be naturally occurring orsynthetic. For example, lipids include the fatty droplets that naturallyoccur in the cytoplasm as well as the class of compounds that are wellknown to those of skill in the art that contain long-chain aliphatichydrocarbons and their derivatives, such as fatty acids, alcohols,amines, amino alcohols, and aldehydes. An example is the lipid1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC).

Lipid compositions of the present invention may comprise phospholipids.In certain embodiments, a single kind or type of phospholipid may beused in the creation of lipid compositions, such as liposomes. In otherembodiments, more than one kind or type of phospholipid may be used.

Phospholipids include glycerophospholipids and certain sphingolipids.Phospholipids include, but are not limited to,dioleoylphosphatidylycholine (“DOPC”), egg phosphatidylcholine (“EPC”),dilauryloylphosphatidylcholine (“DLPC”), dimyristoylphosphatidylcholine(“DMPC”), dipalmitoylphosphatidylcholine (“DPPC”), distearoylphosphatidylcholine (“DSPC”), dilinoleoylphosphatidylcholine,1,2-diarachidoyl-sn-glycero-3-phosphocholine (“DAPC”),1,2-dieicosenoyl-sn-glycero-3-phosphocholine (“DEPC”),1-myristoyl-2-palmitoyl phosphatidylcholine (“MPPC”),1-palmitoyl-2-myristoyl phosphatidylcholine (“PMPC”),1-palmitoyl-2-stearoyl phosphatidylcholine (“PSPC”),1-stearoyl-2-palmitoyl phosphatidylcholine (“SPPC”), palmitoyloeoylphosphatidylcholine (“POPC”), 1-oleoyl-2-palmitoyl phosphatidylcholine(“OPPC”), dilauryloylphosphatidylglycerol (“DLPG”),dimyristoylphosphatidylglycerol (“DMPG”),dipalmitoylphosphatidylglycerol (“DPPG”), distearoylphosphatidylglycerol (“DSPG”), dioleoylphosphatidylglycerol(“DOPG”), dimyristoyl phosphatidic acid (“DMPA”), dipalmitoylphosphatidic acid (“DPPA”), distearoyl phosphatidic acid (“DSPA”),dioleoyl phosphatidic acid (“DOPA”), dimyristoylphosphatidylethanolamine (“DMPE”), dipalmitoyl phosphatidylethanolamine(“DPPE”), di stearoylphophatidylethanolamine (“D SPE”),dioleoylphosphatidylethanolamine (“DOPE”), palmitoyloeoylphosphatidyletlianolamine (“POPE”), dimyristoyl phosphatidylserine(“DMPS”), dipalmitoyl phosphatidylserine (“DPPS”), brainphosphatidylserine (“BPS”), distearoyl sphingomyelin (“DSSP”), brainsphingomyelin (“BSP”), dipalmitoyl sphingomyelin (“DPSP”),lysophosphatidylcholine, and lysophosphatidylethanolamine.

Phospholipids include, for example, phosphatidylcholines,phosphatidylglycerols, and phosphatidylethanolamines; becausephosphatidylethanolamines and phosphatidylcholines are non-charged underphysiological conditions (i.e., at about pH 7), these compounds may beparticularly useful for generating neutral liposomes. In certainembodiments, the phospholipid DOPC is used to produce non-chargedliposomes or lipid compositions. In certain embodiments, a lipid that isnot a phospholipid (e.g., a cholesterol) can also be used

Phospholipids may be from natural or synthetic sources. However,phospholipids from natural sources, such as egg or soybeanphosphatidylcholine, brain phosphatidic acid, brain or plantphosphatidylinositol, heart cardiolipin, and plant or bacterialphosphatidylethanolamine, are not used in certain embodiments as theprimary phosphatide (i.e., constituting 50% or more of the totalphosphatide composition) because this may result in instability andleakiness of the resulting liposomes.

B. Neutral Liposomes

“Neutral liposomes or lipid composition” or “non-charged liposomes orlipid composition,” as used herein, are defined as liposomes or lipidcompositions having one or more lipids that yield an essentially-neutralnet charge (substantially non-charged). In certain embodiments, neutralliposomes or lipid compositions may include mostly lipids and/orphospholipids that are themselves neutral. In certain embodiments,amphipathic lipids may be incorporated into or used to generate neutralliposomes or lipid compositions. For example, a neutral liposome may begenerated by combining positively and negatively charged lipids so thatthose charges substantially cancel one another, thereby yielding anessentially-neutral net charge. By “essentially neutral” or “essentiallynon-charged,” it is meant that few, if any, lipids within a givenpopulation (e.g., a population of liposomes) include a charge that isnot canceled by an opposite charge of another component (e.g., fewerthan 10% of components include a non-canceled charge, more preferablyfewer than 5%, and most preferably fewer than 1%). In certainembodiments of the present invention, a composition may be preparedwherein the lipid component of the composition is essentially neutralbut is not in the form of liposomes.

The size of the liposomes varies depending on the method of synthesis. Aliposome suspended in an aqueous solution is generally in the shape of aspherical vesicle, and may have one or more concentric layers of lipidbilayer molecules. Each layer consists of a parallel array of moleculesrepresented by the formula XY, wherein X is a hydrophilic moiety and Yis a hydrophobic moiety. In aqueous suspension, the concentric layersare arranged such that the hydrophilic moieties tend to remain incontact with an aqueous phase and the hydrophobic regions tend toself-associate. For example, when aqueous phases are present within theliposome, the lipid molecules may form a bilayer, known as a lamella, ofthe arrangement XY-YX. Aggregates of lipids may form when thehydrophilic and hydrophobic parts of more than one lipid molecule becomeassociated with each other. The size and shape of these aggregates willdepend upon many different variables, such as the nature of the solventand the presence of other compounds in the solution.

Liposomes within the scope of the present invention can be prepared inaccordance with known laboratory techniques, such as, for example, themethod of Bangham et al. (1965), the contents of which are incorporatedherein by reference; the method of Gregoriadis (1979), the contents ofwhich are incorporated herein by reference; the method of Deamer andUster (1983), the contents of which are incorporated by reference; andthe reverse-phase evaporation method as described by Szoka andPapahadjopoulos (1978). The aforementioned methods differ in theirrespective abilities to entrap aqueous material and their respectiveaqueous space-to-lipid ratios.

In certain embodiments, a neutral liposome may be used to deliver anoligonucleotide, such as an antisense oligonucleotide. The neutralliposome may contain a single species of oligonucleotide directed to thesuppression of translation of a single gene, or the neutral liposome maycontain multiple species of oligonucleotides that are directed to thesuppression of translation of multiple genes. Further, the neutralliposome may also contain a chemotherapeutic in addition to theoligonucleotide; thus, in certain embodiments, a chemotherapeutic and anoligonucleotide may be delivered to a cell (e.g., a cancerous cell in ahuman subject) in the same or separate compositions.

Dried lipids or lyophilized liposomes may be dehydrated andreconstituted at an appropriate concentration with a suitable solvent(e.g., DPBS or Hepes buffer). The mixture may then be vigorously shakenin a vortex mixer. The liposomes may be resuspended at an appropriatetotal phospholipid concentration (e.g., about 10-200 mM). Unencapsulatedoligonucleotide may be removed by centrifugation at 29,000 g and theliposomal pellets washed. Alternatively, the unencapsulatedoligonucleotides may be removed by dialyzing against an excess ofsolvent. The amount of oligonucleotide encapsulated can be determined inaccordance with standard methods.

II. INHIBITION OF GENE EXPRESSION

An inhibitory oligonucleotide can inhibit the transcription ortranslation of a gene in a cell. An oligonucleotide may be from 5 to 50or more nucleotides long, and in certain embodiments from 7 to 30nucleotides long. In certain embodiments, the oligonucleotide maybe 7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25,26, 27, 28, 29, or 30 nucleotides long. The oligonucleotide may comprisea nucleic acid and/or a nucleic acid analog. Typically, an inhibitoryoligonucleotide will inhibit the translation of a single gene within acell; however, in certain embodiments, an inhibitory oligonucleotide mayinhibit the translation of more than one gene within a cell.

Within an oligonucleotide, the components of the oligonucleotide neednot be of the same type or homogenous throughout (e.g., anoligonucleotide may comprise a nucleotide and a nucleic acid ornucleotide analog). In certain embodiments of the present invention, theoligonucleotide may comprise only a single nucleic acid or nucleic acidanalog. The inhibitory oligonucleotide may comprise 5, 6, 7, 8, 9, 10,11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 25, 30 or more contiguousnucleobases, including all ranges therebetween, that hybridize with acomplementary nucleic acid to form a double-stranded structure.

III. NUCLEIC ACIDS

The present invention provides methods and compositions for the deliveryof an oligonucleotide via neutral liposomes. Because an oligonucleotideis composed of a nucleic acid, methods relating to nucleic acids (e.g.,production of a nucleic acid, modification of a nucleic acid, etc.) mayalso be used with regard to an oligonucleotide.

The term “nucleic acid” is well known in the art. A “nucleic acid” asused herein generally refers to a molecule (i.e., a strand) of DNA, RNA,or a derivative or analog thereof, comprising a nucleobase. Thesedefinitions refer to a single-stranded or double-stranded nucleic acid.Double-stranded nucleic acids may be formed by fully complementarybinding; however, in some embodiments, a double-stranded nucleic acidmay be formed by partial or substantial complementary binding. As usedherein, a single-stranded nucleic acid may be denoted by the prefix “ss”and a double-stranded nucleic acid by the prefix “ds.”

A. Nucleobases

As used herein a “nucleobase” refers to a heterocyclic base, such as,for example, a naturally occurring nucleobase (i.e., an A, T, G, C or U)found in at least one naturally occurring nucleic acid (i.e., DNA andRNA), and naturally or non-naturally occurring derivative(s) and analogsof such a nucleobase. A nucleobase generally can form one or morehydrogen bonds (i.e., “anneal” or “hybridize”) with at least onenaturally occurring nucleobase in a manner that may substitute fornaturally occurring nucleobase pairing (e.g., the hydrogen bondingbetween A and T, G and C, and A and U). A nucleobase may be comprised ina nucleoside or nucleotide, using any chemical or natural synthesismethod described herein or known to one of ordinary skill in the art.

“Purine” and/or “pyrimidine” nucleobase(s) encompass naturally occurringpurine and/or pyrimidine nucleobases and also derivative(s) andanalog(s) thereof, including but not limited to, a purine or pyrimidinesubstituted by one or more of an alkyl, carboxyalkyl, amino, hydroxyl,halogen (i.e., fluoro, chloro, bromo, or iodo), thiol, or alkylthiolmoiety. Preferred alkyl (e.g., alkyl, caboxyalkyl, etc.) moietiescomprise of from about 1, about 2, about 3, about 4, about 5, to about 6carbon atoms. Other non-limiting examples of a purine or pyrimidineinclude a deazapurine, a 2,6-diaminopurine, a 5-fluorouracil, axanthine, a hypoxanthine, a 8-bromoguanine, a 8-chloroguanine, abromothyline, a 8-aminoguanine, a 8-hydroxyguanine, a 8-methylguanine, a8-thioguanine, an azaguanine, a 2-aminopurine, a 5-ethylcytosine, a5-methylcyosine, a 5-bromouracil, a 5-ethyluracil, a 5-iodouracil, a5-chlorouracil, a 5-propyluracil, a thiouracil, a 2-methyladenine, amethylthioadenine, a N,N-diemethyladenine, an azaadenines, a8-bromoadenine, a 8-hydroxyadenine, a 6-hydroxyaminopurine, a6-thiopurine, a 4-(6-aminohexyl/cytosine), and the like. Purine andpyrimidine derivatives or analogs include, but are not limited to(abbreviation/modified base description): ac4c/4-acetylcytidine,Mam5s2u/5-methoxyaminomethyl-2-thiouridine,Chm5u/5-(carboxyhydroxylmethyl) uridine, Man q/Beta, D-mannosylqueosine,Cm/2′-O-methylcytidine, Mcm5s2u/5-methoxycarbonylmethyl-2-thiouridine,Cmnm5s2u/5-carboxymethylamino-methyl-2-thioridine,Mcm5u/5-methoxycarbonylmethyluridine,Cmnm5u/5-carboxymethylaminomethyluridine, Mo5u/5-methoxyuridine,D/Dihydrouridine, Ms2i6a, 2-methylthio-N6-isopentenyladenosine,Fm/2′-O-methylpseudouridine,Ms2t6a/N-((9-beta-D-ribofuranosyl-2-methylthiopurine-6-yl)carbamoyl)threonine,Gal q/Beta,D-galactosylqueosine,Mt6a/N-((9-beta-D-ribofuranosylpurine-6-yl)N-methyl-carbamoyl)threonine,Gm/2′-O-methylguanosine, Mv/Uridine-5-oxyacetic acid methylester,I/Inosine, o5u/Uridine-5-oxyacetic acid (v),I6a/N6-isopentenyladenosine, Osyw/Wybutoxosine, m1a/1-methyladenosine,P/Pseudouridine, m1f/1-methylpseudouridine, Q/Queosine,m1g/1-methylguanosine, s2c/2-thiocytidine, m1I/1-methylinosine,s2t/5-methyl-2-thiouridine, m22g/2,2-dimethylguanosine,s2u/2-thiouridine, m2a/2-methyladenosine, s4u/4-thiouridine,m2g/2-methylguanosine, T/5-methyluridine, m3c/3-methylcytidine,t6a/N-((9-beta-D-ribofuranosylpurine-6-yl)carbamoyl)threonine,m5c/5-methylcytidine, Tm/2′-O-methyl-5-methyluridine,m6a/N6-methyladenosine, Um/2′-O-methyluridine, m7g/7-methylguanosine,Yw/Wybutosine, Mam5u/5-methylaminomethyluridine, orX/3-(3-amino-3-carboxypropyl)uridine, (acp3)u.

B. Nucleosides

As used herein, a “nucleoside” refers to an individual chemical unitcomprising a nucleobase covalently attached to a nucleobase linkermoiety. A non-limiting example of a “nucleobase linker moiety” is asugar comprising 5-carbon atoms (i.e., a “5-carbon sugar”), includingbut not limited to a deoxyribose, a ribose, an arabinose, or aderivative or an analog of a 5-carbon sugar. Non-limiting examples of aderivative or an analog of a 5-carbon sugar include a2′-fluoro-2′-deoxyribose or a carbocyclic sugar where a carbon issubstituted for an oxygen atom, in the sugar ring. As used herein, a“moiety” generally refers to a smaller chemical or molecular componentof a larger chemical or molecular structure.

Different types of covalent attachment(s) of a nucleobase to anucleobase linker moiety are known in the art. By way of non-limitingexample, a nucleoside comprising a purine (i.e., A or G) or a7-deazapurine nucleobase typically comprises a covalent attachment ofthe 9 position of the purine or 7-deazapurine to a 1′-position of a5-carbon sugar. In another non-limiting example, a nucleoside comprisinga pyrimidine nucleobase (i.e., C, T, or U) typically comprises acovalent attachment of the 1 position of the pyrimidine to a 1′-positionof a 5-carbon sugar (Kornberg and Baker, 1992).

C. Nucleotides

As used herein, a “nucleotide” refers to a nucleoside further comprisinga “backbone linkage.” A backbone linkage generally covalently attaches anucleotide to another molecule comprising a nucleotide, or to anothernucleotide to form a nucleic acid. The “backbone linkage” in naturallyoccurring nucleotides typically comprises a phosphate moiety (e.g., aphosphodiester backbone linkage), which is covalently attached to a5-carbon sugar. The attachment of the backbone moiety typically occursat either the 3′- or 5′-position of the 5-carbon sugar. However, othertypes of attachments are known in the art, particularly when anucleotide comprises derivatives or analogs of a naturally occurring5-carbon sugar or phosphate moiety.

D. Nucleic Acid Analogs

A nucleic acid may comprise, or be composed entirely of, a derivative oranalog of a nucleobase, a nucleobase linker moiety, and/or backbonelinkage that may be present in a naturally occurring nucleic acid. Asused herein a “derivative” refers to a chemically modified or alteredform of a naturally occurring molecule, while the terms “mimic” or“analog” refer to a molecule that may or may not structurally resemble anaturally occurring molecule or moiety, but possesses similar functions.Nucleobase, nucleoside, and nucleotide analogs or derivatives are wellknown in the art.

Non-limiting examples of nucleosides, nucleotides, or nucleic acidscomprising 5-carbon sugar and/or backbone linkage derivatives oranalogs, include those in U.S. Pat. No. 5,681,947 which describesoligonucleotides comprising purine derivatives that form triple helixeswith and/or prevent expression of dsDNA; U.S. Pat. Nos. 5,652,099 and5,763,167 which describe nucleic acids incorporating fluorescent analogsof nucleosides found in DNA or RNA, particularly for use as fluorescentnucleic acids probes; U.S. Pat. No. 5,614,617 which describesoligonucleotide analogs with substitutions on pyrimidine rings thatpossess enhanced nuclease stability; U.S. Pat. Nos. 5,670,663, 5,872,232and 5,859,221 which describe oligonucleotide analogs with modified5-carbon sugars (i.e., modified 2′-deoxyfuranosyl moieties) used innucleic acid detection; U.S. Pat. No. 5,446,137 which describesoligonucleotides comprising at least one 5-carbon sugar moietysubstituted at the 4′ position with a substituent other than hydrogenthat can be used in hybridization assays; U.S. Pat. No. 5,886,165 whichdescribes oligonucleotides with both deoxyribonucleotides with 3′-5′backbone linkages and ribonucleotides with 2′-5′ backbone linkages; U.S.Pat. No. 5,714,606 which describes a modified backbone linkage wherein a3′-position oxygen of the backbone linkage is replaced by a carbon toenhance the nuclease resistance of nucleic acids; U.S. Pat. No.5,672,697 which describes oligonucleotides containing one or more 5′methylene phosphonate backbone linkages that enhance nucleaseresistance; U.S. Pat. Nos. 5,466,786 and 5,792,847 which describe thelinkage of a substituent moiety that may comprise a drug or label to the2′ carbon of an oligonucleotide to provide enhanced nuclease stabilityand ability to deliver drugs or detection moieties; U.S. Pat. No.5,223,618 which describes oligonucleotide analogs with a 2 or 3 carbonbackbone linkage attaching the 4′ position and 3′ position of adjacent5-carbon sugar moiety to enhanced cellular uptake, resistance tonucleases, and hybridization to target RNA; U.S. Pat. No. 5,470,967which describes oligonucleotides comprising at least one sulfamate orsulfamide backbone linkage that are useful as nucleic acid hybridizationprobes; U.S. Pat. Nos. 5,378,825, 5,777,092, 5,623,070, 5,610,289 and5,602,240 which describe oligonucleotides with a three or four atombackbone linkage moiety replacing the phosphodiester backbone linkageused for improved nuclease resistance, cellular uptake, and regulatingRNA expression; U.S. Pat. No. 5,858,988 which describes hydrophobiccarrier agent attached to the 2′-O position of oligonucleotides toenhance their membrane permeability and stability; U.S. Pat. No.5,214,136 which describes oligonucleotides conjugated to anthraquinoneat the 5′ terminus that possess enhanced hybridization to DNA or RNA;enhanced stability to nucleases; U.S. Pat. No. 5,700,922 which describesPNA-DNA-PNA chimeras wherein the DNA comprises2′-deoxy-erythro-pentofaranosyl nucleotides for enhanced nucleaseresistance, binding affinity, and ability to activate RNase H; U.S. Pat.No. 5,708,154 which describes RNA linked to a DNA to form a DNA-RNAhybrid; U.S. Pat. No. 5,908,845 which describes polyether nucleic acidswherein one or more nucleobases are linked to chiral carbon atoms in apolyether backbone; U.S. Pat. Nos. 5,786,461, 5,891,625, 5,786,461,5,773,571, 5,766,855, 5,736,336, 5,719,262, 5,714,331, 5,539,082, and WO92/20702 which describe peptide nucleic acids (PNA or peptide-basednucleic acid analog; or PENAM) that generally comprise one or morenucleotides or nucleosides that comprise a nucleobase moiety, anucleobase linker moiety that is not a 5-carbon sugar (e.g., azanitrogen atoms, amido and/or ureido tethers), and/or a backbone linkagethat is not a phosphate backbone linkage (e.g., aminoethylglycine,polyamide, polyethyl, polythioamide, polysulfinamide, or polysulfonamidebackbone linkage); and U.S. Pat. No. 5,855,911 which describes thehydrophobic, nuclease resistant P-ethoxy backbone linkage.

Other modifications and uses of nucleic acid analogs are known in theart, and it is anticipated that these techniques and types of nucleicacid analogs may be used with the present invention.

E. Preparation of Nucleic Acids

A nucleic acid may be made by any technique known to one of ordinaryskill in the art, such as chemical synthesis, enzymatic production orbiological production. Non-limiting examples of a synthetic nucleic acid(e.g., a synthetic oligonucleotide) include a nucleic acid made by invitro chemical synthesis using phosphotriester, phosphite, orphosphoramidite chemistry and solid phase techniques, such as describedin EP 266,032, incorporated herein by reference, or by deoxynucleosideH-phosphonate intermediates as described by Froehler et al. (1986) andU.S. Pat. No. 5,705,629, each incorporated herein by reference. In themethods of the present invention, one or more species of oligonucleotidemay be used. Various mechanisms of oligonucleotide synthesis have beendisclosed in, for example, U.S. Pat. Nos. 4,659,774, 4,816,571,5,141,813, 5,264,566, 4,959,463, 5,428,148, 5,554,744, 5,574,146,5,602,244, each of which is incorporated herein by reference.

F. Purification of Nucleic Acids

A nucleic acid may be purified on polyacrylamide gels, cesium chloridecentrifugation gradients, or by any other means known to one of ordinaryskill in the art (see for example, Sambrook et al. (2001), incorporatedherein by reference).

In certain embodiments, the present invention concerns a nucleic acidthat is an isolated nucleic acid. As used herein, the term “isolatednucleic acid” refers to a nucleic acid molecule (e.g., an RNA or DNAmolecule) that has been isolated free of, or is otherwise free of, thebulk of the total genomic and transcribed nucleic acids of one or morecells. In certain embodiments, “isolated nucleic acid” refers to anucleic acid that has been isolated free of, or is otherwise free of,the bulk of cellular components or in vitro reaction components, suchas, for example, macromolecules, such as lipids or proteins, smallbiological molecules, and the like.

G. Hybridization

As used herein, “hybridization,” “hybridize(s),” or “capable ofhybridizing” is understood to mean the forming of a double or triplestranded molecule or a molecule with partial double or triple strandednature. The term “anneal” as used herein is synonymous with “hybridize.”

As used herein “stringent condition(s)” or “high stringency” are thoseconditions that allow hybridization between or within one or morenucleic acid strand(s) containing complementary sequence(s), butprecludes hybridization of random sequences. Stringent conditionstolerate little, if any, mismatch between a nucleic acid and a targetstrand. Such conditions are well known to those of ordinary skill in theart, and are preferred for applications requiring high selectivity.

Stringent conditions may comprise low salt and/or high temperatureconditions, such as provided by about 0.02 M to about 0.15 M NaCl attemperatures of about 50° C. to about 70° C. It is understood that thetemperature and ionic strength of a desired stringency are determined inpart by the length of the particular nucleic acid(s), the length andnucleobase content of the target sequence(s), the charge composition ofthe nucleic acid(s), and to the presence or concentration of formamide,tetramethylammonium chloride, or other solvent(s) in a hybridizationmixture.

It is also understood that these ranges, compositions and conditions forhybridization are mentioned by way of non-limiting examples only, andthat the desired stringency for a particular hybridization reaction isoften determined empirically by comparison to one or more positive ornegative controls. Depending on the application envisioned it ispreferred to employ varying conditions of hybridization to achievevarying degrees of selectivity of a nucleic acid towards a targetsequence. In a non-limiting example, identification or isolation of arelated target nucleic acid that does not hybridize to a nucleic acidunder stringent conditions may be achieved by hybridization at lowtemperature and/or high ionic strength. Such conditions are termed “lowstringency” or “low stringency conditions,” and non-limiting examples oflow stringency include hybridization performed at about 0.15 M to about0.9 M NaCl at a temperature range of about 20° C. to about 50° C. Ofcourse, it is within the skill of one in the art to further modify thelow or high stringency conditions to suit a particular application.

IV. METHOD OF MANUFACTURING LIPOSOMAL P-ETHOXY ANTISENSE DRUG PRODUCT

Antisense oligonucleotides (oligos) complementary to specific regions ofa target mRNA have been used to inhibit the expression of endogenousgenes. When the antisense oligonucleotides bind to a target mRNA, aDNA-RNA hybrid is formed. This hybrid formation inhibits the translationof the mRNA and, thus, the expression of the encoded protein. If theprotein is essential for the survival of the cell, the inhibition of itsexpression may lead to cell death. Therefore, antisense oligonucleotidescan be useful tools in anticancer and antiviral therapies.

The main obstacles in using antisense oligonucleotides to inhibit geneexpression are cellular instability, low cellular uptake, and poorintercellular delivery. Natural phosphodiesters are not resistant tonuclease hydrolysis; thus high concentrations of antisenseoligonucleotides are needed before any inhibitory effect is observed.Modified phosphodiester analogs, such as P-ethoxy, have been made toovercome this nuclease hydrolysis problem, but they have not provided asatisfactory solution to the problem.

The cellular uptake of antisense oligonucleotides is low. To solve thisproblem, physical techniques, such as calcium-phosphate precipitation,DEAE-dextran mediation, or electroporation, have been used to increasethe cellular uptake of oligonucleotides. These techniques are difficultto reproduce and are inapplicable in vivo. Cationic lipids, such asLipofectin, have also been used to deliver oligonucleotides. Anelectrostatic interaction is formed between the cationic lipids and thenegatively charged oligonucleotides, which results in a complex that isthen taken up by the target cells. Since these cationic lipids do notprotect the oligonucleotides from nuclease digestion and are harmful tothe cell membrane, they are only useful in delivering thenuclease-resistant phosphorothioates, but not the nuclease-cleavablephosphodiesters.

Another modified phosphodiester analog that has been prepared isP-ethoxy. The P-ethoxy antisense backbone does not have an adverseeffect on bleeding and complement activation, which are some of thetoxicities that have been reported for other antisense analogs. Themodifications of P-ethoxy oligonucleotides are made in the phosphatebackbone so that the modification will not interfere with the binding ofthese oligonucleotides to a target mRNA. P-ethoxy oligonucleotides aremade by adding an ethyl group to the non-bridging oxygen atom of thephosphate backbone, thus rendering these oligonucleotides unchargedcompounds. In spite of their resistance to nucleases, the cellularuptake and intracellular delivery of P-ethoxy oligonucleotides is poorbecause upon internalization, these oligonucleotides remain sequesteredinside the endosomal/lysosomal vacuoles, impeding their access to targetmRNA.

A. P-Ethoxy Antisense Drug Product

The liposomal P-ethoxy antisense drug product is composed of two cGMPproducts, both of which have a FDA-required Certificate of Analysis withFDA-approved release criteria. The raw materials, solvents, and finaldrug product are described herein. When manufactured, the drug productis a lyophilized crystal or powder of amber or white color thatcomprises the following materials: oligonucleotide (e.g., P-ethoxyantisense drug substance), neutral lipids (e.g., DOPC), and surfactant(e.g., polysorbate 20). In preparation for administration to a patient,normal saline is added to the vial, at which time liposomes are formedwith the P-ethoxy antisense incorporated into the interior.

B. P-Ethoxy Antisense Drug Substance

Specific physical properties (e.g., solubility and hydrophobicity, whichthen affect drug product solubility in saline, incorporation of oligointo liposomes, and liposome particle size) of the finished product canbe defined using a pre-determined P-ethoxy and phosphodiester amiditeraw material mix during production of the P-ethoxy antisense drugsubstance. While loss of the P-ethoxy backbone group randomly occursduring oligonucleotide manufacturing resulting in phosphodiester bondsat those linkages, that loss may not generate the preferred ratio ofP-ethoxy: phosphodiester backbone linkage within the oligonucleotide. Inthis case, the mix of P-ethoxy and phosphodiester amidite raw materialsupplements the expected value of P-ethoxy backbone deletions, thusgenerating an oligonucleotide with the desired ratio. Increasing thenumber of P-ethoxy molecules in the backbone of the oligonucleotidecauses the molecule to be more hydrophobic (which results in largerliposome particles; Table 1), less polar, and less soluble (Table 2).Methods of testing the charge-neutral, hydrophobic P-ethoxy drugsubstance include mass spectrometry to determine the distribution ofoligonucleotide lengths and assays to determine the solubility of drugsubstance, which for practical purposes for solubility is a visualinspection of the drug product reconstituted in saline. As theoligonucleotide becomes less soluble due to a greater number of P-ethoxybackbone linkages the reconstituted solution becomes whiter untilparticulates form as hydrophobicity becomes too high.

Formulation must use a particle size, wherein the 90% value is less than5000 nm in size and is soluble, which is a function of the nucleotidecomposition. By way of example, if an oligonucleotide is 18-20nucleotides in length, then at least five of the phosphate backbonelinkages should be phosphodiester backbone linkages. This is supportedby the Experiments 7-10 below in Table 1, which provides data from 18meroligonucleotides. Wherein if an oligonucleotide is 25 nucleotides inlength, then at least six of the phosphate backbone linkages should bephosphodiester backbone linkages.

TABLE 1 Liposome Particle Size Variability with Antisense BackboneComposition Particle Size Characteristics: Post-Manufacturing CumulativeDistribution Function Backbone Ethyl Deletion 90% 50% 300 nm EngineeredPrincipal Composite Value Value Value Experiment Antisense BackbonePeak^(d) Deletion^(e) (nm) ** (nm) (%) 1 3 amidite substitution −6 −5.672130 911 15.30 2 3 amidite substitution −6 −5.67 2420 1004 15.50 3 3amidite substitution −6 −6.12 3682 943 15.50 4 3 amidite substitution −7−6.66 3805 978 14.60 5 100% P-ethoxy −5 −5.66 3924 976 16.00 6 2 amiditesubstitution −5 −5.32 4387 1888 11.60  7^(a) 100% P-ethoxy −4 −4.22 50571131 17.70 8 100% P-ethoxy −4 −4.52 5659 1359 10.00  9^(b) 100% P-ethoxy−4 −4.38 7571 1909 2.60 10^(c) 100% P-ethoxy −4 −4.38 7994 1653 14.40 **Drug product release criteria is for 90% of the liposome particles to beless than or equal to 5000 nm. ^(a)This lot was discarded due to poorsolubility; specifically, antisense particles in the reconstitutedsolution. ^(b)This lot had lower DMSO and tBA volume with 2 mg antisensein a 20 mL vial, which added an additional component to liposomeenlargement. ^(c)This lot was not released because it failed theparticle size release spec. ^(d)The principal peak represents the mostcommon number of p-ethoxy deletions in the oligonucleotides of thepopulation. ^(e)The composite deletion represents the average number ofp-ethoxy deletions in the population of oligonucleotides.

TABLE 2 Liposome Particle Solubility with Antisense Backbone CompositionPost-Manufacturing Backbone Ethyl Deletion Drug Solubility EngineeredVisual Solubility Experi- Antisense Principal Composite ObservationAssess- ment Backbone Peak Deletion ** ment 1 3 amidite −6 −5.67 skimmilk good substitution solution 2 3 amidite −6 −5.67 skim milk goodsubstitution solution 3 3 amidite −6 −6.12 skim milk good substitutionsolution 4 3 amidite −7 −6.66 skim milk good substitution solution 5100% P- −5 −5.66 skim milk good ethoxy solution 6 2 amidite −5 −5.32skim milk good substitution solution 7 100% P- −4 −4.52 white passethoxy solution 8^(b) 100% P- −4 −4.38 white pass ethoxy solution 9^(c)100% P- −4 −4.38 white pass ethoxy solution 10^(a) 100% P- −4 −4.22white fail ethoxy solution particles ** If the drug product sample hasparticles the lot will be rejected ^(a)This lot was discarded due topoor solubility; specifically, antisense particles in the reconstitutedsolution. ^(b)This lot had lower DMSO and tBA volume with 2 mg antisensein a 20 mL vial, which added an additional component to liposomeenlargement. ^(c)This lot was not released because it failed theparticle size release spec.

C. Formulation, Filtration, and Lyophilization of Liposomal P-EthoxyAntisense Drug Product

One gram (1 g) of pE oligos is dissolved in DMSO at a ratio of 10 mgoligonucleotide per 1 mL DMSO. Next, DOPC is added to tert-butyl alcoholat a ratio of 1 g DOPC per 1719 mL of tert-butyl alcohol. The oligo andDOPC are combined and mixed at a ratio of 1 g oligonucleotide per 2.67 gDOPC. Then, 20 mL of a 0.835% (v/v) solution of polysorbate 20 is addedto the mixture resulting in a final concentration of 0.039 mg/mL. Thesolution is passed through a sterile filter prior to dispensing intoglass vials for lyophilization.

The effect of the surfactant on liposome particle size was determined bytitrating the amount of surfactant (Table 3). In the absence ofpolysorbate 20, only 2.8% of the particles had a diameter of 300 nm orless. In the presence of 1× polysorbate 20, 12.5% of the particles had adiameter of 300 nm or less. With the addition of 3×-10× polysorbate 20,around 20% of the particles had a diameter of 300 nm or less. Thus anincrease in surfactant from 1× to 3× results in a decrease in particlesize.

TABLE 3 Liposome Particle Size Variability with Surfactant Particle SizeCharacteristics: Amount of Cumulative Distribution Function ExperimentSurfactant 50% Value 90% Value ** 300 nm Value 1  0× 5301 nm 10719 nm 2.8% 2  1× 1053 nm  4054 nm 12.5% 3  3×  785 nm  2926 nm 19.1% 4  5× 721 nm  2691 nm 21.9% 5 10×  734 nm  2937 nm 21.4% ** Drug productrelease criteria is for 90% of the liposome particles to be less than orequal to 5000 nm.

D. Preparation of Liposomal P-Ethoxy Antisense Drug Product forAdministration

The lyophilized preparation was hydrated with normal saline (0.9%/10 mMNaCl) at a final oligo concentration of 10-5000 μM. Theliposomal-P-ethoxy oligos were mixed by hand shaking.

E. Methods of Testing Liposomal P-Ethoxy Antisense Drug Product

Visual Inspection of Manufactured Drug Product: After manufacturing, asample vial containing drug product is selected and visually inspected.The absence of liquid is mandatory, and then amber crystals at thebottom of the vial are acceptable, and increasing in acceptance to awhite, flocculated powder or appearance, the best result. The whiteappearance indicates a better drying process, with a high surface areato mass ratio, which is very conducive to reconstitution for use.

Visual Inspection of Reconstituted Drug Ready for Patient IV: Normalsaline is added to a vial containing the manufactured Liposomal P-ethoxyAntisense Drug Product and shaken to reconstitute into a solution withthe drug crystal or powder completely dissolved. Three main observationsare made: 1) that the crystal or powder is completely dissolved, 2)there are no white clumps of undissolved material, and 3) the appearanceis a milky white or skim milk appearance. The bluer the appearance ofthe reconstituted liquid, the better, as this signals a smaller liposomeparticle size that reflects light in the blue spectrum.

Mass Spectrometry: Mass spectrometry (mass spec) is used to display theprofile of the various masses in a sample. When P-ethoxy antisensematerial is produced, a mass spec is run on the sample. The result showspeaks of material present on a grid that has increasing mass on the “x”axis to the right, and relative mass abundance on the “y” axisincreasing upward. The profile from a sample is analyzed to determinethe relative quantity of P-ethoxy backbones in the P-ethoxy sample,recognizing that the profile of peaks represents (starting farthest tothe right), full length material with all backbones comprised of theP-ethoxy linkage, the next peak moving left a full length with onebackbone with a P-ethoxy deletion (and therefore, the ethyl beingknocked off and the result being a normal phosphodiester backbonelinkage), and continuing. The mass spec pattern shifted to the rightrepresents a P-ethoxy sample having more P-ethoxy backbones, andtherefore having the properties of being more hydrophobic and lesssoluble; and likewise, shifted to the left having the opposite effects.Inspection of the mass spec chart of a sample also can be used todetermine if filtration during manufacturing produces any adverseeffects on oligonucleotide composition present in the filtered drugproduct.

UV Testing: Ultraviolent light testing is used to determine the mass ofoligonucleotide present in a sample. Oligonucleotides absorb light inthe 260 nanometer range. As a result, UV testing of the finishedreconstituted drug product has come to be used as a method indetermining the quantity of oligonucleotide drug substance in a vial ofdrug product. In terms of manufacturing development and innovations, UVtesting was used to determine if there were problems experienced duringfiltration in manufacturing or poor solubility of the P-ethoxy antisensedrug substance, resulting in less oligonucleotide in solution andtherefore a lower UV reading. The method will be validated and likelybecome part of the final product release testing.

Liposome Particle Size: A vial of finished drug product is reconstitutedand tested for liposome particle size. The result is often a roughlynormal distribution, having a central point, tails and average values ora roughly normal distribution of the majority of the particles andsmaller, secondary peaks of the smaller liposomes particles resultingfrom second-order particle formation effects. It is important thatliposome particles not be too large, as they may create adverse effectsin patients (for example, create blood flow problems in smaller bloodvessels in the lungs). As a result, the drug product release criteriainclude that particle size testing show that 90% of liposomes be 5microns or less in size. In addition, smaller liposomes are preferredbecause they will have better uptake into cells, and secondly, smallerliposomes can penetrate vascular pores, thereby allowing the liposomesto penetrate inside tumors, increasing treatment effectiveness of aLiposomal P-ethoxy Antisense Drug Product.

V. METHODS OF TREATMENT

Certain aspects of the present invention provide anoligonucleotide-lipid complex (e.g., an oligonucleotide incorporatedinto a non-charged liposome) for treating diseases, such as cancer,autoimmune disease, or infectious disease. Particularly, theoligonucleotide may have a sequence that allows for base pairing with ahuman nucleotide sequence and thus may inhibit the expression of aprotein encoded by the human nucleotide sequence.

“Treatment” and “treating” refer to administration or application of atherapeutic agent to a subject or performance of a procedure or modalityon a subject for the purpose of obtaining a therapeutic benefit of adisease or health-related condition. For example, a treatment mayinclude administration of a pharmaceutically effective amount of anoligonucleotide-lipid complex.

“Subject” and “patient” refer to either a human or non-human, such asprimates, mammals, and vertebrates. In particular embodiments, thesubject is a human.

The term “therapeutic benefit” or “therapeutically effective” as usedthroughout this application refers to anything that promotes or enhancesthe well-being of the subject with respect to the medical treatment ofthis condition. This includes, but is not limited to, a reduction in thefrequency or severity of the signs or symptoms of a disease. Forexample, treatment of cancer may involve, for example, a reduction inthe size of a tumor, a reduction in the invasiveness of a tumor,reduction in the growth rate of the cancer, or prevention of metastasis.Treatment of cancer may also refer to prolonging survival of a subjectwith cancer. Treatment of an autoimmune disease may involve, forexample, reducing the expression of a self-antigen against which thereis an undesired immune response, inducing tolerance of a self-antigenagainst which there is an undesired immune response, or inhibiting theimmune response towards the self-antigen. Treatment of an infectiousdisease may involve, for example, eliminate the infectious agent, reducethe level of the infectious agent, or maintain the level of theinfectious agent at a certain level.

Tumors for which the present treatment methods are useful include anymalignant cell type, such as those found in a solid tumor, ahematological tumor, metastatic cancer, or non-metastatic cancer.Exemplary solid tumors can include, but are not limited to, a tumor ofan organ selected from the group consisting of pancreas, colon, cecum,esophagus, gastrointestine, gum, liver, skin, stomach, testis, tongue,uterus, stomach, brain, head, neck, ovary, kidney, larynx, sarcoma,bone, lung, bladder, melanoma, prostate, and breast. Exemplaryhematological tumors include tumors of the bone marrow, T or B cellmalignancies, leukemias, lymphomas, such as, for example, diffuse largeB-cell lymphoma, blastomas, myelomas, and the like. Further examples ofcancers that may be treated using the methods provided herein include,but are not limited to, carcinoma, lymphoma, blastoma, sarcoma,leukemia, squamous cell cancer, lung cancer (including small-cell lungcancer, non-small cell lung cancer, adenocarcinoma of the lung, andsquamous carcinoma of the lung), cancer of the peritoneum,hepatocellular cancer, gastric or stomach cancer (includinggastrointestinal cancer and gastrointestinal stromal cancer), pancreaticcancer, glioblastoma, cervical cancer, ovarian cancer, liver cancer,bladder cancer, breast cancer, colon cancer, colorectal cancer,endometrial or uterine carcinoma, salivary gland carcinoma, kidney orrenal cancer, prostate cancer, vulval cancer, thyroid cancer, varioustypes of head and neck cancer, melanoma, superficial spreading melanoma,lentigo malignant melanoma, acral lentiginous melanomas, nodularmelanomas, as well as B-cell lymphoma (including low grade/follicularnon-Hodgkin's lymphoma (NHL); small lymphocytic (SL) NHL; intermediategrade/follicular NHL; intermediate grade diffuse NHL; high gradeimmunoblastic NHL; high grade lymphoblastic NHL; high grade smallnon-cleaved cell NHL; bulky disease NHL; diffuse large B-cell lymphoma;mantle cell lymphoma; AIDS-related lymphoma; and Waldenstrom'smacroglobulinemia), chronic lymphocytic leukemia (CLL), acutelymphoblastic leukemia (ALL), Hairy cell leukemia, multiple myeloma,acute myeloid leukemia (AML) and chronic myeloblastic leukemia.

The cancer may specifically be of the following histological type,though it is not limited to these: neoplasm, malignant; carcinoma;carcinoma, undifferentiated; giant and spindle cell carcinoma; smallcell carcinoma; papillary carcinoma; squamous cell carcinoma;lymphoepithelial carcinoma; basal cell carcinoma; pilomatrix carcinoma;transitional cell carcinoma; papillary transitional cell carcinoma;adenocarcinoma; gastrinoma, malignant; cholangiocarcinoma;hepatocellular carcinoma; combined hepatocellular carcinoma andcholangiocarcinoma; trabecular adenocarcinoma; adenoid cystic carcinoma;adenocarcinoma in adenomatous polyp; adenocarcinoma, familial polyposiscoli; solid carcinoma; carcinoid tumor, malignant; branchiolo-alveolaradenocarcinoma; papillary adenocarcinoma; chromophobe carcinoma;acidophil carcinoma; oxyphilic adenocarcinoma; basophil carcinoma; clearcell adenocarcinoma; granular cell carcinoma; follicular adenocarcinoma;papillary and follicular adenocarcinoma; nonencapsulating sclerosingcarcinoma; adrenal cortical carcinoma; endometroid carcinoma; skinappendage carcinoma; apocrine adenocarcinoma; sebaceous adenocarcinoma;ceruminous adenocarcinoma; mucoepidermoid carcinoma; cystadenocarcinoma;papillary cystadenocarcinoma; papillary serous cystadenocarcinoma;mucinous cystadenocarcinoma; mucinous adenocarcinoma; signet ring cellcarcinoma; infiltrating duct carcinoma; medullary carcinoma; lobularcarcinoma; inflammatory carcinoma; paget's disease, mammary; acinar cellcarcinoma; adenosquamous carcinoma; adenocarcinoma w/squamousmetaplasia; thymoma, malignant; ovarian stromal tumor, malignant;thecoma, malignant; granulosa cell tumor, malignant; androblastoma,malignant; sertoli cell carcinoma; leydig cell tumor, malignant; lipidcell tumor, malignant; paraganglioma, malignant; extra-mammaryparaganglioma, malignant; pheochromocytoma; glomangiosarcoma; malignantmelanoma; amelanotic melanoma; superficial spreading melanoma; malignantmelanoma in giant pigmented nevus; epithelioid cell melanoma; bluenevus, malignant; sarcoma; fibrosarcoma; fibrous histiocytoma,malignant; myxosarcoma; liposarcoma; leiomyosarcoma; rhabdomyosarcoma;embryonal rhabdomyosarcoma; alveolar rhabdomyosarcoma; stromal sarcoma;mixed tumor, malignant; mullerian mixed tumor; nephroblastoma;hepatoblastoma; carcinosarcoma; mesenchymoma, malignant; brenner tumor,malignant; phyllodes tumor, malignant; synovial sarcoma; mesothelioma,malignant; dysgerminoma; embryonal carcinoma; teratoma, malignant;struma ovarii, malignant; choriocarcinoma; mesonephroma, malignant;hemangiosarcoma; hemangioendothelioma, malignant; kaposi's sarcoma;hemangiopericytoma, malignant; lymphangiosarcoma; osteosarcoma;juxtacortical osteosarcoma; chondrosarcoma; chondroblastoma, malignant;mesenchymal chondrosarcoma; giant cell tumor of bone; ewing's sarcoma;odontogenic tumor, malignant; ameloblastic odontosarcoma; ameloblastoma,malignant; ameloblastic fibrosarcoma; pinealoma, malignant; chordoma;glioma, malignant; ependymoma; astrocytoma; protoplasmic astrocytoma;fibrillary astrocytoma; astroblastoma; glioblastoma; oligodendroglioma;oligodendroblastoma; primitive neuroectodermal; cerebellar sarcoma;ganglioneuroblastoma; neuroblastoma; retinoblastoma; olfactoryneurogenic tumor; meningioma, malignant; neurofibrosarcoma;neurilemmoma, malignant; granular cell tumor, malignant; malignantlymphoma; hodgkin's disease; hodgkin's; paragranuloma; malignantlymphoma, small lymphocytic; malignant lymphoma, large cell, diffuse;malignant lymphoma, follicular; mycosis fungoides; other specifiednon-hodgkin's lymphomas; malignant histiocytosis; multiple myeloma; mastcell sarcoma; immunoproliferative small intestinal disease; leukemia;lymphoid leukemia; plasma cell leukemia; erythroleukemia; lymphosarcomacell leukemia; myeloid leukemia; basophilic leukemia; eosinophilicleukemia; monocytic leukemia; mast cell leukemia; megakaryoblasticleukemia; myeloid sarcoma; and hairy cell leukemia.

Autoimmune diseases for which the present treatment methods are usefulinclude, without limitation, spondyloarthropathy, ankylosingspondylitis, psoriatic arthritis, reactive arthritis, enteropathicarthritis, diabetes mellitus, celiac disease, autoimmune thyroiddisease, autoimmune liver disease, Addison's disease, transplantrejection, graft vs. host disease, host vs. graft disease, ulcerativecolitis, Crohn's disease, irritable bowel disease, inflammatory boweldisease, rheumatoid arthritis, juvenile rheumatoid arthritis, familialMediterranean fever, amyotrophic lateral sclerosis, Sjogren's syndrome,early arthritis, viral arthritis, multiple sclerosis, or psoriasis. Thediagnosis and treatment of these diseases are well documented in theliterature.

Infectious diseases for which the present treatment methods are usefulinclude, without limitation, bacterial infections, viral infections,fungal infections, and parasitic infections. Exemplary viral infectionsinclude hepatitis B virus, hepatitis C virus, human immunodeficiencyvirus 1, human immunodeficiency virus 2, human papilloma virus, herpessimplex virus 1, herpes simplex virus 2, herpes zoster, varicellazoster, coxsackievirus A16, cytomegalovirus, ebola virus, enterovirus,Epstein-Barr virus, hanta virus, hendra virus, viral meningitis,respiratory syncytial virus, rotavirus, west nile virus, adenovirus, andinfluenza virus infections. Exemplary bacterial infections includeChlamydia trachomatis, Listeria monocytogenes, Helicobacter pylori,Escherichia coli, Borelia burgdorferi, Legionella pneumophilia,Mycobacteria sps (e.g., M. tuberculosis, M. avium, M. intracelluiar e,M. kansaii, M. gordonae), Staphylococcus aureus, Neisseria gonorrhoeae,Neisseria meningitides, Streptococcus pyogenes (Group A Streptococcus),Streptococcus agalactiae (Group B Streptococcus), Streptococcus(viridans group), Streptococcus faecalis, Streptococcus bovis,Streptococcus (anaerobic sps.), Streptococcus pneumoniae, pathogenicCampylobacter sp., Enterococcus sp., Haemophilus influenzae, Bacillusanthracis, Corynebacterium diphtherias, corynebacterium sp.,Erysipelothrix rhusiopathiae, Clostridium perfringens, Clostridiumtetani, Enterobacter aerogenes, Klebsiella pneumoniae, Pasteurellamultocida, Bacteroides sp., Fusobacterium nucleatum, Streptobacillusmoniliformis, Treponema pallidium, Treponema pertenue, Leptospira,Rickettsia, Actinomyces israelli, Shigella sps (e.g., S. flexneri, S.sonnei, S. dysenteriae), and Salmonella spp infections. Exemplary fungalinfections include Candida albicans, Candida glabrata, Aspergillusfumigatus, Aspergillus terreus, Cryptococcus neoformans, Histoplasmacapsulatum, Coccidioides immitis, Blastomyces dermatitidis, andChlamydia trachomatis infections.

The oligonucleotide-lipid complex may be used herein as an antitumor,antiviral, antibacterial, antifungal, antiparasite, or anti-autoimmuneagent in a variety of modalities. In a particular embodiment, theinvention contemplates methods of using an oligonucleotide-lipid complexcomprises contacting a population of diseased cells with atherapeutically effective amount of an oligonucleotide-lipid complex fora time period sufficient to inhibit or reverse disease.

In one embodiment, the contacting in vivo is accomplished byadministering, by intravenous, intraperitoneal, subcutaneous, orintratumoral injection, a therapeutically effective amount of aphysiologically tolerable composition comprising anoligonucleotide-lipid complex of this invention to a patient. Theoligonucleotide-lipid complex can be administered parenterally byinjection or by gradual infusion over time.

Therapeutic compositions comprising oligonucleotide-lipid complex areconventionally administered intravenously or subcutaneously, such as byinjection of a unit dose, for example. The term “unit dose” when used inreference to a therapeutic composition refers to physically discreteunits suitable as unitary dosage for the subject, each unit containing apredetermined quantity of active material calculated to produce thedesired therapeutic effect in association with the required diluent,i.e., carrier, or vehicle.

The compositions are administered in a manner compatible with the dosageformulation, and in a therapeutically effective amount. The quantity tobe administered depends on the subject to be treated, capacity of thesubject's system to utilize the active ingredient, and degree oftherapeutic effect desired. Precise amounts of active ingredientrequired to be administered depend on the judgment of the practitionerand are peculiar to each individual. However, suitable dosage ranges forsystemic application are disclosed herein and depend on the route ofadministration. Suitable regimes for initial and booster administrationare also contemplated and are typified by an initial administrationfollowed by repeated doses at one or more hour intervals by a subsequentinjection or other administration. Exemplary multiple administrationsare described herein and are particularly preferred to maintaincontinuously high serum and tissue levels of polypeptide. Alternatively,continuous intravenous infusion sufficient to maintain concentrations inthe blood in the ranges specified for in vivo therapies arecontemplated.

It is contemplated that an oligonucleotide of the invention can beadministered systemically or locally to treat disease, such as toinhibit tumor cell growth or to kill cancer cells in cancer patientswith locally advanced or metastatic cancers. They can be administeredintravenously, intrathecally, subcutaneously, and/or intraperitoneally.They can be administered alone or in combination with anti-proliferativedrugs. In one embodiment, they are administered to reduce the cancerload in the patient prior to surgery or other procedures. Alternatively,they can be administered after surgery to ensure that any remainingcancer (e.g., cancer that the surgery failed to eliminate) does notsurvive.

A therapeutically effective amount of an oligonucleotide is apredetermined amount calculated to achieve the desired effect, i.e., toinhibit the expression of a target protein. Thus, the dosage ranges forthe administration of oligonucleotides of the invention are those largeenough to produce the desired effect. The dosage should not be so largeas to cause adverse side effects, such as hyperviscosity syndromes,pulmonary edema, congestive heart failure, neurological effects, and thelike. Generally, the dosage will vary with age of, condition of, sex of,and extent of the disease in the patient and can be determined by one ofskill in the art. The dosage can be adjusted by the individual physicianin the event of any complication.

A composition of the present invention is preferably administered to apatient parenterally, for example by intravenous, intraarterial,intramuscular, intralymphatic, intraperitoneal, subcutaneous,intrapleural, or intrathecal injection, or may be used ex vivo.Preferred dosages are between 5-25 mg/kg. The administration ispreferably repeated on a timed schedule until the cancer disappears orregresses, and may be in conjunction with other forms of therapy.

VI. PHARMACEUTICAL PREPARATIONS

A pharmaceutical composition comprising the liposomes will usuallyinclude a sterile, pharmaceutically acceptable carrier or diluent, suchas dextrose or saline solution.

Where clinical application of non-charged lipid component (e.g., in theform of a liposome) containing an oligonucleotide is undertaken, it willgenerally be beneficial to prepare the lipid complex as a pharmaceuticalcomposition appropriate for the intended application. This willtypically entail preparing a pharmaceutical composition that isessentially free of pyrogens, as well as any other impurities that couldbe harmful to humans or animals. One may also employ appropriate buffersto render the complex stable and allow for uptake by target cells.

The phrases “pharmaceutical or pharmacologically acceptable” refers tomolecular entities and compositions that do not produce an adverse,allergic or other untoward reaction when administered to an animal, suchas a human, as appropriate. The preparation of a pharmaceuticalcomposition that contains at least one non-charged lipid componentcomprising an oligonucleotide or additional active ingredient will beknown to those of skill in the art in light of the present disclosure,as exemplified by Remington: The Science and Practice of Pharmacy, 21st,2005, incorporated herein by reference. Moreover, for animal (e.g.,human) administration, it will be understood that preparations shouldmeet sterility, pyrogenicity, general safety and purity standards asrequired by FDA Office of Biological Standards.

As used herein, “pharmaceutically acceptable carrier” includes any andall solvents, dispersion media, coatings, surfactants, antioxidants,preservatives (e.g., antibacterial agents, antifungal agents), isotonicagents, absorption delaying agents, salts, preservatives, drugs, drugstabilizers, gels, binders, excipients, disintegration agents,lubricants, sweetening agents, flavoring agents, dyes, such likematerials and combinations thereof, as would be known to one of ordinaryskill in the art. A pharmaceutically acceptable carrier is preferablyformulated for administration to a human, although in certainembodiments it may be desirable to use a pharmaceutically acceptablecarrier that is formulated for administration to a non-human animal butwhich would not be acceptable (e.g., due to governmental regulations)for administration to a human. Except insofar as any conventionalcarrier is incompatible with the active ingredient, its use in thetherapeutic or pharmaceutical compositions is contemplated.

The actual dosage amount of a composition of the present inventionadministered to a patient or subject can be determined by physical andphysiological factors such as body weight, severity of condition, thetype of disease being treated, previous or concurrent therapeuticinterventions, idiopathy of the patient and on the route ofadministration. The practitioner responsible for administration will, inany event, determine the concentration of active ingredient(s) in acomposition and appropriate dose(s) for the individual subject.

In certain embodiments, pharmaceutical compositions may comprise, forexample, at least about 0.1% of an active compound. In otherembodiments, the an active compound may comprise between about 2% toabout 75% of the weight of the unit, or between about 25% to about 60%,for example, and any range derivable therein. In other non-limitingexamples, a dose may also comprise from about 1 microgram/kg/bodyweight, about microgram/kg/body weight, about 10 microgram/kg/bodyweight, about 50 microgram/kg/body weight, about 100 microgram/kg/bodyweight, about 200 microgram/kg/body weight, about 350 microgram/kg/bodyweight, about 500 microgram/kg/body weight, about 1 milligram/kg/bodyweight, about 5 milligram/kg/body weight, about 10 milligram/kg/bodyweight, about 50 milligram/kg/body weight, about 100 milligram/kg/bodyweight, about 200 milligram/kg/body weight, about 350 milligram/kg/bodyweight, about 500 milligram/kg/body weight, to about 1000 mg/kg/bodyweight or more per administration, and any range derivable therein. Innon-limiting examples of a derivable range from the numbers listedherein, a range of about 5 μg/kg/body weight to about 1000 mg/kg/bodyweight, about 5 microgram/kg/body weight to about 500 milligram/kg/bodyweight, etc., can be administered.

An oligonucleotide of the present embodiments may be administered in adose of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 40, 50, 60, 70,80, 90, 100 or more μg of nucleic acid per dose. Each dose may be in avolume of 1, 10, 50, 100, 200, 500, 1000 or more μl or ml.

Solutions of therapeutic compositions can be prepared in water suitablymixed with a surfactant, such as hydroxypropylcellulose. Dispersionsalso can be prepared in glycerol, liquid polyethylene glycols, mixturesthereof and in oils. Under ordinary conditions of storage and use, thesepreparations contain a preservative to prevent the growth ofmicroorganisms.

The therapeutic compositions of the present invention are advantageouslyadministered in the form of injectable compositions either as liquidsolutions or suspensions; solid forms suitable for solution in, orsuspension in, liquid prior to injection may also be prepared. Thesepreparations also may be emulsified. A typical composition for suchpurpose comprises a pharmaceutically acceptable carrier. For instance,the composition may contain 10 mg, 25 mg, 50 mg or up to about 100 mg ofhuman serum albumin per milliliter of phosphate buffered saline. Otherpharmaceutically acceptable carriers include aqueous solutions,non-toxic excipients, including salts, preservatives, buffers and thelike.

Examples of non-aqueous solvents are propylene glycol, polyethyleneglycol, vegetable oil and injectable organic esters such as ethyloleate.Aqueous carriers include water, alcoholic/aqueous solutions, salinesolutions, parenteral vehicles such as sodium chloride, Ringer'sdextrose, etc. Intravenous vehicles include fluid and nutrientreplenishers. Preservatives include antimicrobial agents, anti-oxidants,chelating agents and inert gases. The pH and exact concentration of thevarious components the pharmaceutical composition are adjusted accordingto well known parameters.

The therapeutic compositions of the present invention may includeclassic pharmaceutical preparations. Administration of therapeuticcompositions according to the present invention will be via any commonroute so long as the target tissue is available via that route. Thisincludes oral, nasal, buccal, rectal, vaginal or topical. Topicaladministration may be particularly advantageous for the treatment ofskin cancers, to prevent chemotherapy-induced alopecia or other dermalhyperproliferative disorder. Alternatively, administration may be byorthotopic, intradermal, subcutaneous, intramuscular, intraperitoneal orintravenous injection. Such compositions would normally be administeredas pharmaceutically acceptable compositions that include physiologicallyacceptable carriers, buffers or other excipients. For treatment ofconditions of the lungs, aerosol delivery can be used. Volume of theaerosol is between about 0.01 ml and 0.5 ml.

An effective amount of the therapeutic composition is determined basedon the intended goal. The term “unit dose” or “dosage” refers tophysically discrete units suitable for use in a subject, each unitcontaining a predetermined-quantity of the therapeutic compositioncalculated to produce the desired responses discussed above inassociation with its administration, i.e., the appropriate route andtreatment regimen. The quantity to be administered, both according tonumber of treatments and unit dose, depends on the protection or effectdesired.

Precise amounts of the therapeutic composition also depend on thejudgment of the practitioner and are peculiar to each individual.Factors affecting the dose include the physical and clinical state ofthe patient, the route of administration, the intended goal of treatment(e.g., alleviation of symptoms versus cure) and the potency, stabilityand toxicity of the particular therapeutic substance.

VII. COMBINATION TREATMENTS

In certain embodiments, the compositions and methods of the presentinvention involve an inhibitory oligonucleotide, or oligonucleotidecapable of expressing an inhibitor of gene expression, in combinationwith a second or additional therapy. The methods and compositionsincluding combination therapies enhance the therapeutic or protectiveeffect, and/or increase the therapeutic effect of another anti-cancer oranti-hyperproliferative therapy. Therapeutic and prophylactic methodsand compositions can be provided in a combined amount effective toachieve the desired effect, such as the killing of a cancer cell and/orthe inhibition of cellular hyperproliferation. This process may involvecontacting the cells with both an inhibitor of gene expression and asecond therapy. A tissue, tumor, or cell can be contacted with one ormore compositions or pharmacological formulation(s) including one ormore of the agents (i.e., inhibitor of gene expression or an anti-canceragent), or by contacting the tissue, tumor, and/or cell with two or moredistinct compositions or formulations, wherein one compositionprovides 1) an inhibitory oligonucleotide; 2) an anti-cancer agent, or3) both an inhibitory oligonucleotide and an anti-cancer agent. Also, itis contemplated that such a combination therapy can be used inconjunction with a chemotherapy, radiotherapy, surgical therapy, orimmunotherapy.

An inhibitory oligonucleotide may be administered before, during, afteror in various combinations relative to an anti-cancer treatment. Theadministrations may be in intervals ranging from concurrently to minutesto days to weeks. In embodiments where the inhibitory oligonucleotide isprovided to a patient separately from an anti-cancer agent, one wouldgenerally ensure that a significant period of time did not expirebetween the time of each delivery, such that the two compounds wouldstill be able to exert an advantageously combined effect on the patient.In such instances, it is contemplated that one may provide a patientwith the inhibitory oligonucleotide therapy and the anti-cancer therapywithin about 12 to 24 or 72 h of each other and, more preferably, withinabout 6-12 h of each other. In some situations it may be desirable toextend the time period for treatment significantly where several days(2, 3, 4, 5, 6 or 7) to several weeks (1, 2, 3, 4, 5, 6, 7 or 8) lapsebetween respective administrations.

In certain embodiments, a course of treatment will last 1, 2, 3, 4, 5,6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24,25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42,43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60,61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78,79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90 days or more. It iscontemplated that one agent may be given on day 1, 2, 3, 4, 5, 6, 7, 8,9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26,27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44,45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62,63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80,81, 82, 83, 84, 85, 86, 87, 88, 89, and/or 90, any combination thereof,and another agent is given on day 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30,31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48,49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66,67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84,85, 86, 87, 88, 89, and/or 90, or any combination thereof. Within asingle day (24-hour period), the patient may be given one or multipleadministrations of the agent(s). Moreover, after a course of treatment,it is contemplated that there is a period of time at which noanti-cancer treatment is administered. This time period may last 1, 2,3, 4, 5, 6, 7 days, and/or 1, 2, 3, 4, 5 weeks, and/or 1, 2, 3, 4, 5, 6,7, 8, 9, 10, 11, 12 months or more, depending on the condition of thepatient, such as their prognosis, strength, health, etc.

Various combinations may be employed. For the example below aninhibitory oligonucleotide therapy is “A” and an anti-cancer therapy is“B”:

-   -   A/B/A B/A/B B/B/A A/A/B A/B/B B/A/A A/BBB    -   B/A/B/B BBB/A B/B/A/B A/A/B/B A/B/A/B A/B/B/A    -   B/B/A/A B/A/B/A B/A/A/B A/A/A/B B/A/A/A A/B/A/A    -   A/A/B/A

Administration of any compound or therapy of the present invention to apatient will follow general protocols for the administration of suchcompounds, taking into account the toxicity, if any, of the agents.Therefore, in some embodiments there is a step of monitoring toxicitythat is attributable to combination therapy. It is expected that thetreatment cycles would be repeated as necessary. It also is contemplatedthat various standard therapies, as well as surgical intervention, maybe applied in combination with the described therapy.

In specific aspects, it is contemplated that a standard therapy willinclude chemotherapy, radiotherapy, immunotherapy, surgical therapy orgene therapy and may be employed in combination with the inhibitor ofgene expression therapy, anticancer therapy, or both the inhibitor ofgene expression therapy and the anti-cancer therapy, as describedherein.

A. Chemotherapy

A wide variety of chemotherapeutic agents may be used in accordance withthe present embodiments. The term “chemotherapy” refers to the use ofdrugs to treat cancer. A “chemotherapeutic agent” is used to connote acompound or composition that is administered in the treatment of cancer.These agents or drugs are categorized by their mode of activity within acell, for example, whether and at what stage they affect the cell cycle.Alternatively, an agent may be characterized based on its ability todirectly cross-link DNA, to intercalate into DNA, or to inducechromosomal and mitotic aberrations by affecting nucleic acid synthesis.

Examples of chemotherapeutic agents include alkylating agents, such asthiotepa and cyclosphosphamide; alkyl sulfonates, such as busulfan,improsulfan, and piposulfan; aziridines, such as benzodopa, carboquone,meturedopa, and uredopa; ethylenimines and methylamelamines, includingaltretamine, triethylenemelamine, trietylenephosphoramide,triethiylenethiophosphoramide, and trimethylolomelamine; acetogenins(especially bullatacin and bullatacinone); a camptothecin (including thesynthetic analogue topotecan); bryostatin; callystatin; CC-1065(including its adozelesin, carzelesin and bizelesin syntheticanalogues); cryptophycins (particularly cryptophycin 1 and cryptophycin8); dolastatin; duocarmycin (including the synthetic analogues, KW-2189and CB1-TM1); eleutherobin; pancratistatin; a sarcodictyin;spongistatin; nitrogen mustards, such as chlorambucil, chlornaphazine,cholophosphamide, estramustine, ifosfamide, mechlorethamine,mechlorethamine oxide hydrochloride, melphalan, novembichin,phenesterine, prednimustine, trofosfamide, and uracil mustard;nitrosureas, such as carmustine, chlorozotocin, fotemustine, lomustine,nimustine, and ranimnustine; antibiotics, such as the enediyneantibiotics (e.g., calicheamicin, especially calicheamicin gammall andcalicheamicin omegall); dynemicin, including dynemicin A;bisphosphonates, such as clodronate; an esperamicin; as well asneocarzinostatin chromophore and related chromoprotein enediyneantiobiotic chromophores, aclacinomysins, actinomycin, authrarnycin,azaserine, bleomycins, cactinomycin, carabicin, carminomycin,carzinophilin, chromomycini s, dactinomycin, daunorubicin, detorubicin,6-diazo-5-oxo-L-norleucine, doxorubicin (includingmorpholino-doxorubicin, cyanomorpholino-doxorubicin,2-pyrrolino-doxorubicin and deoxydoxorubicin), epirubicin, esorubicin,idarubicin, marcellomycin, mitomycins, such as mitomycin C, mycophenolicacid, nogalarnycin, olivomycins, peplomycin, potfiromycin, puromycin,quelamycin, rodorubicin, streptonigrin, streptozocin, tubercidin,ubenimex, zinostatin, and zorubicin; anti-metabolites, such asmethotrexate and 5-fluorouracil (5-FU); folic acid analogues, such asdenopterin, pteropterin, and trimetrexate; purine analogs, such asfludarabine, 6-mercaptopurine, thiamiprine, and thioguanine; pyrimidineanalogs, such as ancitabine, azacitidine, 6-azauridine, carmofur,cytarabine, dideoxyuridine, doxifluridine, enocitabine, and floxuridine;androgens, such as calusterone, dromostanolone propionate, epitiostanol,mepitiostane, and testolactone; anti-adrenals, such as mitotane andtrilostane; folic acid replenisher, such as frolinic acid; aceglatone;aldophosphamide glycoside; aminolevulinic acid; eniluracil; amsacrine;bestrabucil; bisantrene; edatraxate; defofamine; demecolcine;diaziquone; elformithine; elliptinium acetate; an epothilone; etoglucid;gallium nitrate; hydroxyurea; lentinan; lonidainine; maytansinoids, suchas maytansine and ansamitocins; mitoguazone; mitoxantrone; mopidanmol;nitraerine; pentostatin; phenamet; pirarubicin; losoxantrone;podophyllinic acid; 2-ethylhydrazide; procarbazine; P SKpolysacchari decomplex; razoxane; rhizoxin; sizofiran; spirogermanium; tenuazonic acid;triaziquone; 2,2′,2″-trichlorotriethylamine; trichothecenes (especiallyT-2 toxin, verracurin A, roridin A and anguidine); urethan; vindesine;dacarbazine; mannomustine; mitobronitol; mitolactol; pipobroman;gacytosine; arabinoside (“Ara-C”); cyclophosphamide; taxoids, e.g.,paclitaxel and docetaxel gemcitabine; 6-thioguanine; mercaptopurine;platinum coordination complexes, such as cisplatin, oxaliplatin, andcarboplatin; vinblastine; platinum; etoposide (VP-16); ifosfamide;mitoxantrone; vincristine; vinorelbine; novantrone; teniposide;edatrexate; daunomycin; aminopterin; xeloda; ibandronate; irinotecan(e.g., CPT-11); topoisomerase inhibitor RFS 2000;difluorometlhylornithine (DMFO); retinoids, such as retinoic acid;capecitabine; carboplatin, procarbazine, plicomycin, gemcitabien,navelbine, farnesyl-protein tansferase inhibitors, transplatinum, andpharmaceutically acceptable salts, acids, or derivatives of any of theabove.

B. Radiotherapy

Other factors that cause DNA damage and have been used extensivelyinclude what are commonly known as γ-rays, X-rays, and/or the directeddelivery of radioisotopes to tumor cells. Other forms of DNA damagingfactors are also contemplated such as microwaves, proton beamirradiation (U.S. Pat. Nos. 5,760,395 and 4,870,287) and UV-irradiation.It is most likely that all of these factors affect a broad range ofdamage on DNA, on the precursors of DNA, on the replication and repairof DNA, and on the assembly and maintenance of chromosomes. Dosageranges for X-rays range from daily doses of 50 to 200 roentgens forprolonged periods of time (3 to 4 wk), to single doses of 2000 to 6000roentgens. Dosage ranges for radioisotopes vary widely, and depend onthe half-life of the isotope, the strength and type of radiationemitted, and the uptake by the neoplastic cells.

The terms “contacted” and “exposed,” when applied to a cell, are usedherein to describe the process by which a therapeutic construct and achemotherapeutic or radiotherapeutic agent are delivered to a targetcell or are placed in direct juxtaposition with the target cell. Toachieve cell killing, for example, both agents are delivered to a cellin a combined amount effective to kill the cell or prevent it fromdividing.

C. Immunotherapy

In the context of cancer treatment, immunotherapeutics, generally, relyon the use of immune effector cells and molecules to target and destroycancer cells. Trastuzumab (Herceptin™) is such an example. The immuneeffector may be, for example, an antibody specific for some marker onthe surface of a tumor cell. The antibody alone may serve as an effectorof therapy or it may recruit other cells to actually affect cellkilling. The antibody also may be conjugated to a drug or toxin(chemotherapeutic, radionuclide, ricin A chain, cholera toxin, pertussistoxin, etc.) and serve merely as a targeting agent. Alternatively, theeffector may be a lymphocyte carrying a surface molecule that interacts,either directly or indirectly, with a tumor cell target. Variouseffector cells include cytotoxic T cells and NK cells. The combinationof therapeutic modalities, i.e., direct cytotoxic activity andinhibition or reduction of ErbB2 would provide therapeutic benefit inthe treatment of ErbB2 overexpressing cancers.

Another immunotherapy could also be used as part of a combined therapywith gen silencing therapy discussed above. In one aspect ofimmunotherapy, the tumor cell must bear some marker that is amenable totargeting, i.e., is not present on the majority of other cells. Manytumor markers exist and any of these may be suitable for targeting inthe context of the present invention. Common tumor markers includecarcinoembryonic antigen, prostate specific antigen, urinary tumorassociated antigen, fetal antigen, tyrosinase (p9′7), gp68, TAG-72,HMFG, Sialyl Lewis Antigen, MucA, MucB, PLAP, estrogen receptor, lamininreceptor, erb B and p155. An alternative aspect of immunotherapy is tocombine anticancer effects with immune stimulatory effects. Immunestimulating molecules also exist including: cytokines such as IL-2,IL-4, IL-12, GM-CSF, gamma-IFN, chemokines such as MIP-1, MCP-1, IL-8and growth factors such as FLT3 ligand. Combining immune stimulatingmolecules, either as proteins or using gene delivery in combination witha tumor suppressor has been shown to enhance anti-tumor effects.Moreover, antibodies against any of these compounds can be used totarget the anti-cancer agents discussed herein.

Examples of immunotherapies currently under investigation or in use areimmune adjuvants e.g., Mycobacterium bovis, Plasmodium falciparum,dinitrochlorobenzene and aromatic compounds (U.S. Pat. Nos. 5,801,005and 5,739,169; Hui and Hashimoto, 1998; Christodoulides et al., 1998),cytokine therapy, e.g., interferons α, β and γ; IL-1, GM-CSF and TNF(Bukowski et al., 1998; Davidson et al., 1998; Hellstrand et al., 1998)gene therapy, e.g., TNF, IL-1, IL-2, p53 (Qin et al., 1998; Austin-Wardand Villaseca, 1998; U.S. Pat. Nos. 5,830,880 and 5,846,945) andmonoclonal antibodies, e.g., anti-ganglioside GM2, anti-HER-2, anti-p185(Pietras et al., 1998; Hanibuchi et al., 1998; U.S. Pat. No. 5,824,311).It is contemplated that one or more anti-cancer therapies may beemployed with the gene silencing therapies described herein.

In active immunotherapy, an antigenic peptide, polypeptide or protein,or an autologous or allogenic tumor cell composition or “vaccine” isadministered, generally with a distinct bacterial adjuvant (Ravindranathand Morton, 1991; Morton et al., 1992; Mitchell et al., 1990; Mitchellet al., 1993).

In adoptive immunotherapy, the patient's circulating lymphocytes, ortumor infiltrated lymphocytes, are isolated in vitro, activated bylymphokines such as IL-2 or transduced with genes for tumor necrosis,and readministered (Rosenberg et al., 1988; 1989).

In some embodiments, the immunotherapy may be an immune checkpointinhibitor. Immune checkpoints either turn up a signal (e.g.,co-stimulatory molecules) or turn down a signal. Inhibitory immunecheckpoints that may be targeted by immune checkpoint blockade includeadenosine A2A receptor (A2AR), B7-H3 (also known as CD276), B and Tlymphocyte attenuator (BTLA), cytotoxic T-lymphocyte-associated protein4 (CTLA-4, also known as CD152), indoleamine 2,3-dioxygenase (IDO),killer-cell immunoglobulin (KIR), lymphocyte activation gene-3 (LAG3),programmed death 1 (PD-1), T-cell immunoglobulin domain and mucin domain3 (TIM-3) and V-domain Ig suppressor of T cell activation (VISTA). Inparticular, the immune checkpoint inhibitors target the PD-1 axis and/orCTLA-4.

The immune checkpoint inhibitors may be drugs such as small molecules,recombinant forms of ligand or receptors, or, in particular, areantibodies, such as human antibodies (e.g., International PatentPublication WO2015016718; Pardoll, Nat Rev Cancer, 12(4): 252-64, 2012;both incorporated herein by reference). Known inhibitors of the immunecheckpoint proteins or analogs thereof may be used, in particularchimerized, humanized or human forms of antibodies may be used. As theskilled person will know, alternative and/or equivalent names may be inuse for certain antibodies mentioned in the present disclosure. Suchalternative and/or equivalent names are interchangeable in the contextof the present disclosure. For example, it is known that lambrolizumabis also known under the alternative and equivalent names MK-3475 andpembrolizumab.

In some embodiments, the PD-1 binding antagonist is a molecule thatinhibits the binding of PD-1 to its ligand binding partners. In aspecific aspect, the PD-1 ligand binding partners are PDL1 and/or PDL2.In another embodiment, a PDL1 binding antagonist is a molecule thatinhibits the binding of PDL1 to its binding partners. In a specificaspect, PDL1 binding partners are PD-1 and/or B7-1. In anotherembodiment, the PDL2 binding antagonist is a molecule that inhibits thebinding of PDL2 to its binding partners. In a specific aspect, a PDL2binding partner is PD-1. The antagonist may be an antibody, an antigenbinding fragment thereof, an immunoadhesin, a fusion protein, oroligopeptide. Exemplary antibodies are described in U.S. Pat. Nos.8,735,553, 8,354,509, and 8,008,449, all incorporated herein byreference. Other PD-1 axis antagonists for use in the methods providedherein are known in the art such as described in U.S. Patent PublicationNos. 20140294898, 2014022021, and 20110008369, all incorporated hereinby reference.

In some embodiments, the PD-1 binding antagonist is an anti-PD-1antibody (e.g., a human antibody, a humanized antibody, or a chimericantibody). In some embodiments, the anti-PD-1 antibody is selected fromthe group consisting of nivolumab, pembrolizumab, and CT-011. In someembodiments, the PD-1 binding antagonist is an immunoadhesin (e.g., animmunoadhesin comprising an extracellular or PD-1 binding portion ofPDL1 or PDL2 fused to a constant region (e.g., an Fc region of animmunoglobulin sequence). In some embodiments, the PD-1 bindingantagonist is AMP-224. Nivolumab, also known as MDX-1106-04, MDX-1106,ONO-4538, BMS-936558, and OPDIVO®, is an anti-PD-1 antibody described inWO2006/121168. Pembrolizumab, also known as MK-3475, Merck 3475,lambrolizumab, KEYTRUIDA®, and SCH-900475, is an anti-PD-1 antibodydescribed in WO2009/114335. CT-011, also known as hBAT or hBAT-1, is ananti-PD-1 antibody described in WO2009/101611. AMP-224, also known asB7-DCIg, is a PDL2-Fc fusion soluble receptor described in WO2010/027827and WO2011/066342.

Another immune checkpoint that can be targeted in the methods providedherein is the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), alsoknown as CD152. The complete cDNA sequence of human CTLA-4 has theGenbank accession number L15006. CTLA-4 is found on the surface of Tcells and acts as an “off” switch when bound to CD80 or CD86 on thesurface of antigen-presenting cells. CTLA4 is a member of theimmunoglobulin superfamily that is expressed on the surface of Helper Tcells and transmits an inhibitory signal to T cells. CTLA4 is similar tothe T-cell co-stimulatory protein, CD28, and both molecules bind to CD80and CD86, also called B7-1 and B7-2 respectively, on antigen-presentingcells. CTLA4 transmits an inhibitory signal to T cells, whereas CD28transmits a stimulatory signal. Intracellular CTLA4 is also found inregulatory T cells and may be important to their function. T cellactivation through the T cell receptor and CD28 leads to increasedexpression of CTLA-4, an inhibitory receptor for B7 molecules.

In some embodiments, the immune checkpoint inhibitor is an anti-CTLA-4antibody (e.g., a human antibody, a humanized antibody, or a chimericantibody), an antigen binding fragment thereof, an immunoadhesin, afusion protein, or oligopeptide.

Anti-human-CTLA-4 antibodies (or VH and/or VL domains derived therefrom)suitable for use in the present methods can be generated using methodswell known in the art. Alternatively, art recognized anti-CTLA-4antibodies can be used. For example, the anti-CTLA-4 antibodiesdisclosed in: U.S. Pat. No. 8,119,129, WO 01/14424, WO 98/42752; WO00/37504 (CP675,206, also known as tremelimumab; formerly ticilimumab),U.S. Pat. No. 6,207,156; Hurwitz et al. (1998) Proc Natl Acad Sci USA95(17): 10067-10071; Camacho et al. (2004) J Clin Oncology 22(145):Abstract No. 2505 (antibody CP-675206); and Mokyr et al. (1998) CancerRes 58:5301-5304 can be used in the methods disclosed herein. Theteachings of each of the aforementioned publications are herebyincorporated by reference. Antibodies that compete with any of theseart-recognized antibodies for binding to CTLA-4 also can be used. Forexample, a humanized CTLA-4 antibody is described in InternationalPatent Application No. WO2001014424, WO2000037504, and U.S. Pat. No.8,017,114; all incorporated herein by reference.

An exemplary anti-CTLA-4 antibody is ipilimumab (also known as 10D1,MDX-010, MDX-101, and Yervoy®) or antigen binding fragments and variantsthereof (see, e.g., WO 01/14424). In other embodiments, the antibodycomprises the heavy and light chain CDRs or VRs of ipilimumab.Accordingly, in one embodiment, the antibody comprises the CDR1, CDR2,and CDR3 domains of the VH region of ipilimumab, and the CDR1, CDR2 andCDR3 domains of the VL region of ipilimumab. In another embodiment, theantibody competes for binding with and/or binds to the same epitope onCTLA-4 as the above-mentioned antibodies. In another embodiment, theantibody has at least about 90% variable region amino acid sequenceidentity with the above-mentioned antibodies (e.g., at least about 90%,95%, or 99% variable region identity with ipilimumab).

Other molecules for modulating CTLA-4 include CTLA-4 ligands andreceptors such as described in U.S. Pat. Nos. 5,844,905, 5,885,796 andInternational Patent Application Nos. WO1995001994 and WO1998042752; allincorporated herein by reference, and immunoadhesins such as describedin U.S. Pat. No. 8,329,867, incorporated herein by reference.

In some embodiment, the immune therapy could be adoptive immunotherapy,which involves the transfer of autologous antigen-specific T cellsgenerated ex vivo. The T cells used for adoptive immunotherapy can begenerated either by expansion of antigen-specific T cells or redirectionof T cells through genetic engineering (Park, Rosenberg et al. 2011).Isolation and transfer of tumor specific T cells has been shown to besuccessful in treating melanoma. Novel specificities in T cells havebeen successfully generated through the genetic transfer of transgenic Tcell receptors or chimeric antigen receptors (CARs) (Jena, Dotti et al.2010). CARs are synthetic receptors consisting of a targeting moietythat is associated with one or more signaling domains in a single fusionmolecule. In general, the binding moiety of a CAR consists of anantigen-binding domain of a single-chain antibody (scFv), comprising thelight and variable fragments of a monoclonal antibody joined by aflexible linker. Binding moieties based on receptor or ligand domainshave also been used successfully. The signaling domains for firstgeneration CARs are derived from the cytoplasmic region of the CD3zetaor the Fc receptor gamma chains. CARs have successfully allowed T cellsto be redirected against antigens expressed at the surface of tumorcells from various malignancies including lymphomas and solid tumors(Jena, Dotti et al. 2010).

In one embodiment, the present application provides for a combinationtherapy for the treatment of cancer wherein the combination therapycomprises adoptive T-cell therapy and a checkpoint inhibitor. In oneaspect, the adoptive T-cell therapy comprises autologous and/orallogenic T cells. In another aspect, the autologous and/or allogenic Tcells are targeted against tumor antigens.

D. Surgery

Approximately 60% of persons with cancer will undergo surgery of sometype, which includes preventative, diagnostic or staging, curative, andpalliative surgery. Curative surgery is a cancer treatment that may beused in conjunction with other therapies, such as the treatment of thepresent invention, chemotherapy, radiotherapy, hormonal therapy, genetherapy, immunotherapy and/or alternative therapies.

Curative surgery includes resection in which all or part of canceroustissue is physically removed, excised, and/or destroyed. Tumor resectionrefers to physical removal of at least part of a tumor. In addition totumor resection, treatment by surgery includes laser surgery,cryosurgery, electrosurgery, and microscopically controlled surgery(Mohs' surgery). It is further contemplated that the present inventionmay be used in conjunction with removal of superficial cancers,precancers, or incidental amounts of normal tissue.

Upon excision of part or all of cancerous cells, tissue, or tumor, acavity may be formed in the body. Treatment may be accomplished byperfusion, direct injection or local application of the area with anadditional anti-cancer therapy. Such treatment may be repeated, forexample, every 1, 2, 3, 4, 5, 6, or 7 days, or every 1, 2, 3, 4, and 5weeks or every 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12 months. Thesetreatments may be of varying dosages as well.

E. Other Agents

It is contemplated that other agents may be used in combination withcertain aspects of the present embodiments to improve the therapeuticefficacy of treatment. These additional agents include agents thataffect the upregulation of cell surface receptors and GAP junctions,cytostatic and differentiation agents, inhibitors of cell adhesion,agents that increase the sensitivity of the hyperproliferative cells toapoptotic inducers, or other biological agents. Increases inintercellular signaling by elevating the number of GAP junctions wouldincrease the anti-hyperproliferative effects on the neighboringhyperproliferative cell population. In other embodiments, cytostatic ordifferentiation agents can be used in combination with certain aspectsof the present embodiments to improve the anti-hyperproliferativeefficacy of the treatments. Inhibitors of cell adhesion are contemplatedto improve the efficacy of the present embodiments. Examples of celladhesion inhibitors are focal adhesion kinase (FAKs) inhibitors andLovastatin. It is further contemplated that other agents that increasethe sensitivity of a hyperproliferative cell to apoptosis, such as theantibody c225, could be used in combination with certain aspects of thepresent embodiments to improve the treatment efficacy.

VIII. KITS AND DIAGNOSTICS

In various aspects of the invention, a kit is envisioned containingtherapeutic agents and/or other therapeutic and delivery agents. In someembodiments, the present invention contemplates a kit for preparingand/or administering a therapy of the invention. The kit may comprisereagents capable of use in administering an active or effective agent(s)of the invention. Reagents of the kit may include at least one inhibitorof gene expression (e.g., a BCL2 oligonucleotide), one or more lipidcomponent, one or more anti-cancer component of a combination therapy,as well as reagents to prepare, formulate, and/or administer thecomponents of the invention or perform one or more steps of theinventive methods.

In some embodiments, the kit may also comprise a suitable containermeans, which is a container that will not react with components of thekit, such as an eppendorf tube, an assay plate, a syringe, a bottle, ora tube. The container may be made from sterilizable materials such asplastic or glass.

The kit may further include an instruction sheet that outlines theprocedural steps of the methods, and will follow substantially the sameprocedures as described herein or are known to those of ordinary skill.

IX. EXAMPLES

The following examples are included to demonstrate preferred embodimentsof the invention. It should be appreciated by those of skill in the artthat the techniques disclosed in the examples which follow representtechniques discovered by the inventor to function well in the practiceof the invention, and thus can be considered to constitute preferredmodes for its practice. However, those of skill in the art should, inlight of the present disclosure, appreciate that many changes can bemade in the specific embodiments which are disclosed and still obtain alike or similar result without departing from the spirit and scope ofthe invention.

Example 1—BCL2-Targeted P-Ethoxy Oligonucleotides

Oligonucleotides targeting BCL2 were designed for use in a liposomalBCL2 antisense drug product to inhibit the expression of Bcl2. Thecontiguous cDNA sequence of BCL2 variant alpha is provided in SEQ ID NO:4 and the protein sequence of BCL2 variant alpha is provided in SEQ IDNO: 5. The contiguous cDNA sequence of BCL2 variant beta is provided inSEQ ID NO: 6 and the protein sequence of BCL2 variant beta is providedin SEQ ID NO: 7. The sequence of each of the oligonucleotides isprovided in Table 4.

TABLE 4 BCL2 antisense sequences Antisense SEQ ID name Sequence NO:20 base^(a) 5′-CAG CGT GCG CCA 1  TCC TTC CC -3′ 18 base^(a)5′-GCG TGC GCC ATC 2  CTT CCC -3′  7 base 5′-TCC TTC C -3′ 3 ^(a)Underlining indicates the location of a known phosphodiesterbackbone linkage

The liposomal BCL2 antisense drug product was manufactured according tothe methods described herein. Mass spectrometry testing for the 20 baseoligonucleotide showed that over 80% of the oligonucleotide drugsubstance had between five and seven phosphodiester backbone linkagesand that over 98% of the oligonucleotide drug substance had between fiveand eight phosphodiester backbone linkages. Particle testing for the 20base oligonucleotide showed that 90% of the liposomes had a particlediameter of 2462 nm or less, 50% of the liposomes had a particlediameter of 607 nm or less, and about 28% of the liposomes had aparticle diameter of 300 nm or less.

Example 2—Inhibition of Normal and Cancer Cell Viability by LiposomalBCL2 Antisense

The ability of liposomal BCL2 antisense to inhibit the viability ofnormal peripheral blood mononuclear cells (PBMCs) was tested. LiposomalBCL2 antisense corresponding to one of SEQ ID NO: 1 with 3× detergent,SEQ ID NO: 2 with 1× detergent, SEQ ID NO: 2 with 3× detergent, and SEQID NO: 3 with 1× detergent was incubated with the cells for four days.As the data in FIG. 1 show, incubation with liposomal BCL2 antisense didnot reduce the cell viability of normal PBMCs.

The ability of liposomal BCL2 antisense to inhibit the viability ofgerminal center B-cell-like subtype diffuse large B cell lymphoma wastested in ten cell lines: DOHH-2, SU-DHL-4, SU-DHL-6, SU-DHL-10,OCI-LY-18, OCI-LY-19, WSU-DLCL2, RL, OCI-LY-1, and OCI-LY-7. LiposomalBCL2 antisense corresponding to one of SEQ ID NO: 1 with 3× detergent,SEQ ID NO: 2 with 1× detergent, SEQ ID NO: 2 with 3× detergent, and SEQID NO: 3 with 1× detergent was incubated with each cell line for fourdays. Cytotoxicity was assessed using a sulforhodamine B cytotoxicityassay. As the data in FIGS. 2A-J show, incubation with liposomal BCL2antisense induced 50% inhibition in six of ten germinal centerB-cell-like subtype diffuse large B cell lymphoma cell lines.

The ability of liposomal BCL2 antisense to inhibit the viability ofactivated B-cell-like subtype diffuse large B cell lymphoma was testedin three cell lines: SU-DHL-2, U-2932, and RI-1. Liposomal BCL2antisense corresponding to one of SEQ ID NO: 1 with 3× detergent, SEQ IDNO: 2 with 1× detergent, SEQ ID NO: 2 with 3× detergent, and SEQ ID NO:3 with 1× detergent was incubated with each cell line for four days.Cytotoxicity was assessed using a sulforhodamine B cytotoxicity assay.As the data in FIGS. 3A-C show, incubation with liposomal BCL2 antisenseinduced 50% inhibition in all three activated B-cell-like subtypediffuse large B cell lymphoma cell lines.

The ability of liposomal BCL2 antisense to inhibit the viability oflymphoma cells was tested in two cell lines: GRANTA-519 (mantle celllymphoma) and Ramos (Burkitt lymphoma). Liposomal BCL2 antisensecorresponding to one of SEQ ID NO: 1 with 3× detergent, SEQ ID NO: 2with 1× detergent, SEQ ID NO: 2 with 3× detergent, and SEQ ID NO: 3 with1× detergent was incubated with each cell line for four days.Cytotoxicity was assessed using a sulforhodamine B cytotoxicity assay.As the data in FIGS. 4A-B show, incubation with liposomal BCL2 antisenseinduced 50% inhibition in both cell lines.

The ability of liposomal BCL2 antisense to inhibit the viability ofmyeloid leukemia cells was tested in three cell lines: K562, MV-4-11,and Kasumi-1. Liposomal BCL2 antisense corresponding to one of SEQ IDNO: 1 with 3× detergent, SEQ ID NO: 2 with 1× detergent, SEQ ID NO: 2with 3× detergent, and SEQ ID NO: 3 with 1× detergent was incubated witheach cell line for four days. Cytotoxicity was assessed using asulforhodamine B cytotoxicity assay. As the data in FIGS. 5A-C show,incubation with liposomal BCL2 antisense induced 50% inhibition in allthree myeloid leukemia cell lines.

All of the methods disclosed and claimed herein can be made and executedwithout undue experimentation in light of the present disclosure. Whilethe compositions and methods of this invention have been described interms of preferred embodiments, it will be apparent to those of skill inthe art that variations may be applied to the methods and in the stepsor in the sequence of steps of the method described herein withoutdeparting from the concept, spirit and scope of the invention. Morespecifically, it will be apparent that certain agents which are bothchemically and physiologically related may be substituted for the agentsdescribed herein while the same or similar results would be achieved.All such similar substitutes and modifications apparent to those skilledin the art are deemed to be within the spirit, scope and concept of theinvention as defined by the appended claims.

REFERENCES

The following references, to the extent that they provide exemplaryprocedural or other details supplementary to those set forth herein, arespecifically incorporated herein by reference.

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What is claimed is:
 1. A composition comprising a population ofoligonucleotides, wherein the oligonucleotides hybridize to a BCL2polynucleotide gene product, wherein oligonucleotides of the populationare composed of nucleoside molecules linked together through phosphatebackbone linkages, wherein at least one of the phosphate backbonelinkages in each oligonucleotide is a P-ethoxy backbone linkage, andwherein no more than 80% of the phosphate backbone linkages in eacholigonucleotide are P-ethoxy backbone linkages.
 2. The composition ofclaim 1, wherein oligonucleotides of the population comprise a sequenceaccording to any one of SEQ ID NOs: 1-3.
 3. The composition of claim 2,wherein oligonucleotides of the population comprise a sequence accordingto SEQ ID NO:
 1. 4. The composition of claim 3, wherein the phosphatebackbone linkages at least between nucleotides 5 and 6, betweennucleotides 7 and 8, between nucleotides 9 and 10, between nucleotides11 and 12, and between nucleotides 14 and 15 of the oligonucleotides ofthe population are phosphodiester backbone linkages.
 5. The compositionof claim 2, wherein oligonucleotides of the population comprise asequence according to SEQ ID NO:
 2. 6. The composition of claim 2,wherein the phosphate backbone linkages at least between nucleotides 5and 6, between nucleotides 7 and 8, and between nucleotides 9 and 10 ofthe oligonucleotides of the population are phosphodiester backbonelinkages.
 7. The composition of claim 2, wherein oligonucleotides of thepopulation comprise a sequence according to SEQ ID NO:
 3. 8. Thecomposition of claim 1, wherein 50% to 80% of the phosphate backbonelinkages are P-ethoxy backbone linkages.
 9. The composition of claim 8,wherein 60% to 75% of the phosphate backbone linkages are P-ethoxybackbone linkages.
 10. The composition of claim 1, wherein 20% to 50% ofthe phosphate backbone linkages are phosphodiester backbone linkages.11. The composition of claim 10, wherein 25% to 40% of the phosphatebackbone linkages are phosphodiester backbone linkages.
 12. Thecomposition of claim 1, wherein the phosphodiester backbone linkages aredistributed throughout each oligonucleotide.
 13. The composition ofclaim 1, wherein the phosphodiester backbone linkages are not clusteredwithin a portion of each oligonucleotide.
 14. The composition of claim1, wherein the population of oligonucleotides is heterogeneous as to thenumber of P-ethoxy backbone linkages and phosphodiester backbonelinkages present in the oligonucleotides of the population.
 15. Thecomposition of claim 1, wherein the oligonucleotides of the populationhave a size ranging from 18 to 30 nucleotides.
 16. The composition ofclaim 15, wherein the oligonucleotides of the population have an averagesize of 18 nucleotides, wherein no more than 14 of the phosphatebackbone linkages in each oligonucleotide is a P-ethoxy backbonelinkage.
 17. The composition of claim 15, wherein the oligonucleotidesof the population have an average size of 20 nucleotides, wherein nomore than 16 of the phosphate backbone linkages in each oligonucleotideis a P-ethoxy backbone linkage.
 18. The composition of claim 15, whereinthe oligonucleotides of the population have an average size of 25nucleotides, wherein no more than 20 of the phosphate backbone linkagesin each oligonucleotide is a P-ethoxy backbone linkage.
 19. Thecomposition of claim 15, wherein the oligonucleotides of the populationhave an average size of 30 nucleotides, wherein no more than 24 of thephosphate backbone linkages in each oligonucleotide is a P-ethoxybackbone linkage.
 20. The composition of claim 1, wherein the populationof oligonucleotides comprises a single species of oligonucleotides. 21.The composition of claim 1, wherein the population of oligonucleotidescomprises at least two species of oligonucleotides.
 22. The compositionof claim 1, wherein the population of oligonucleotides is heterogeneousas to the distribution of phosphodiester backbone linkages among theoligonucleotides of the population.
 23. The composition of claim 1,wherein the oligonucleotides of the population inhibit the expression ofBcl2 protein.
 24. The composition of claim 1, further comprisingphospholipids and wherein the oligonucleotides and phospholipids form anoligonucleotide-lipid complex.
 25. The composition of claim 24, whereinthe phospholipids are uncharged or have a neutral charge at physiologicpH.
 26. The composition of claim 25, wherein the phospholipids areneutral phospholipids.
 27. The composition of claim 26, wherein theneutral phospholipids are phosphatidylcholines.
 28. The composition ofclaim 26, wherein the neutral phospholipids are dioleoylphosphatidylcholine.
 29. The composition of claim 24, wherein the phospholipids areessentially free of cholesterol.
 30. The composition of claim 24,wherein the phospholipids and oligonucleotides are present at a molarratio of from about 5:1 to about 100:1.
 31. The composition of claim 24,wherein the oligonucleotide-lipid complex is further defined as apopulation of liposomes.
 32. The composition of claim 31, wherein atleast 90% of the liposomes are less than 5 microns in diameter.
 33. Thecomposition of claim 31, wherein the population of oligonucleotides isincorporated in the population of liposomes.
 34. The composition ofclaim 1, wherein the composition is lyophilized.
 35. A method forreducing the expression level of Bcl2 protein in a cell comprisingcontacting the cell with a composition of claim
 1. 36. A pharmaceuticalcomposition comprising a composition according to claim 24 and apharmaceutically acceptable carrier.
 37. The composition of claim 36,further comprising a chemotherapeutic agent.
 38. A method for deliveringa therapeutically effective amount of an oligonucleotide to a cellcomprising contacting the cell with a pharmaceutical composition ofclaim
 36. 39. The method of claim 38, wherein the method is a method oftreating hyperplasia, cancer, autoimmune disease, or infectious disease.40. A method of treating a subject with a cancer comprisingadministering to the subject a therapeutically effective amount of apharmaceutical composition of claim
 36. 41. The method of claim 40,wherein the subject is a human.
 42. The method of claim 40, wherein thecancer is a non-small cell lung cancer, pancreatic adenocarcinoma,breast cancer, prostate cancer, melanoma, colon cancer, leukemia,lymphoma, glioblastoma, osteosarcoma, oral cavity cancer, ovariancancer, uterine cancer, bone cancer, brain cancer, prostate cancer,kidney cancer, stomach cancer, esophageal cancer, rectal cancer, bladdercancer, testicular cancer, or liver cancer.
 43. The method of claim 42,wherein the lymphoma is germinal center B-cell-like diffuse large B celllymphoma.
 44. The method of claim 42, wherein the lymphoma is activatedB-cell-like subtype diffuse large B cell lymphoma.
 45. The method ofclaim 42, wherein the lymphoma is mantle cell lymphoma.
 46. The methodof claim 42, wherein the lymphoma is Burkitt lymphoma.
 47. The method ofclaim 42, wherein the leukemia is myeloid leukemia.
 48. The method ofclaim 40, wherein the composition is administered subcutaneously,intravenously, or intraperitoneally.
 49. The method of claim 40, furthercomprising administering at least a second anticancer therapy to thesubject.
 50. The method of claim 49, wherein the second anticancertherapy is a surgical therapy, chemotherapy, radiation therapy,cryotherapy, hormone therapy, immunotherapy, anti-viral therapy, immunesuppression therapy, anti-bacterial therapy, anti-parasite therapy,anti-fungal therapy, or cytokine therapy.
 51. The method of claim 40,wherein administration of the composition reduces expression of Bcl2protein in the patient.